Potentially Problematic Behavior

Examples of

Depression
Suicidal Behavior
Eating Disorders: Anorexia Nervosa, Binge Eating Disorder, and Bulimia
Alcohol and Other Drug Abuse
Mania

Depression

Depression and the variety of ways in which it manifests itself is part of a natural emotional and physical response to lifes ups and downs. Many people will experience periods of reactive (or situational) depression in their lifetime.

Major depression, however, is a  whole-body concern, involving the body, mood, thoughts, and behavior. It affects the way a person eats and sleeps, the way a person feels about him or herself, and the way a person thinks about things.

Major depression is not a passing blue mood. It is not a sign of personal weakness or a condition that can be wished or willed away. People with depression cannot merely pull themselves together. Without treatment, symptoms can last for weeks, months or years. Appropriate treatment, however, can help over 80% of those who suffer from depression.

Symptoms (not necessary for all to be present)

• Persistent sad, anxious or empty mood
• Feelings of hopelessness, pessimism
• Feelings of excessive guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex and school
• Insomnia, early morning awakening or oversleeping
• Appetite and/or weight loss or overeating and weight gain
• Decreased energy, fatigue, being slowed down
• Thoughts of death or suicide attempts
• Restlessness, irritability
• Difficulty in concentrating, remembering, making decisions may affect completion of assignments
• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
• Inconsistent class attendance
• Decline in personal hygiene

Information provided by the National Institute of Mental Health. For additional information about depression see website at:

http://www.nimh.nih.gov/health/publications/depression-a-treatable-illness.shtml

Services are available to the campus community for depression at the WSU Counseling & Testing Center. For more information, call (316) 978-3440 or see their website at http://www.wichita.edu/counselingtesting.
Have more questions? Want more answers? Contact (316) 978-8248 (UBIT)

Suicidal Behavior

Take It Seriously

Seventy-five percent of all suicides give some warning of their intentions to a friend or family member.

All suicide threats and attempts must be taken seriously.

When a person makes any reference to suicide, threat of suicide, or attempt at suicide, a judgment should be made by a mental health professional about the seriousness of a possible suicidal thought or behavior.

References to or threats of self harm should be treated seriously. Mental health evaluations and treatment are available at the Counseling & Testing Center at (316) 978-3440.

Suicide attempts are first and foremost a medical emergency. If dangerous or suicidal behavior appears imminent or has already occurred, contact University Police at (316) 978-3450 or dial 911.

Warning Signs of Suicide

Many suicides can be prevented. While some suicides occur without any outward warning, most people who are suicidal do give warnings. We can prevent some suicides by learning to recognize the signs of someone at risk, taking those signs seriously and knowing how to respond to them.

Warning signs include:

• Observable signs of serious depression:
  Unrelenting low mood
  Pessimism
  Hopelessness
  Desperation
  Anxiety, psychic pain and inner tension
  Withdrawal
  Sleep problems
• Increased alcohol and/or other drug use
• Recent impulsiveness and taking unnecessary risks
• Threatening suicide or expressing a strong wish to die
• Making a plan:
  Verbalizing methods of self harm
  Giving away prized possessions
  Sudden or impulsive purchase of a firearm
  Obtaining other means of killing oneself such as poisons or medications
• Unexpected rage or anger

The emotional crises that usually precede suicide are often recognizable and treatable. Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often it is rather expressed as a loss of pleasure or withdrawal from activities that had been enjoyable. One can help prevent suicide through early recognition and treatment of depression and other psychiatric illnesses.

Information provided by the American Foundation for Suicide Prevention. For more information about suicide, see website at:
http://www.afsp.org/index.cfm?page_id=0519EC1A-D73A-8D90-7D2E9E2456182D66

Crisis intervention services are available to the campus community for suicidal thoughts and intent at the WSU Counseling & Testing Center. For more information, call (316) 978-3440 or see their website at http://www.wichita.edu/counselingtesting.

If a suicide attempt is imminent or has already occurred, this is considered a medical emergency. Please call 911 or University Police at (316) 978-3450. The incident needs to be reported to the University Behavioral Intervention Team, (316) 978-8248, for follow-up.

Eating Disorders: Anorexia Nervosa, Binge Eating Disorder, and Bulimia

Terms and definitions:

Anorexia Nervosa
Anorexia Nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss. There are four primary symptoms:

• Resistance to maintaining body weight at or above a minimally normal weight for age and height.
• Intense fear of weight gain or being fat even though underweight.
• Disturbance in the experience of body weight or shape, undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight.
• Loss of menstrual periods in girls and women post-puberty.

Eating disorders experts have found that prompt intensive treatment significantly improves the chances of recovery. Therefore, it is important to be aware of some of the warning signs of anorexia nervosa.

Warning Signs of Anorexia Nervosa:

• Dramatic weight loss
• Preoccupation with weight, food, calories, fat grams, and dieting
• Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g. no carbohydrates, etc.)
• Frequent comments about feeling fat or overweight despite weight loss
• Anxiety about gaining weight or being fat
• Denial of hunger
• Development of food rituals (e.g. eating foods in certain orders, excessive chewing, rearranging food on a plate)
• Consistent excuses to avoid mealtimes or situations involving food
• Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury--the need to burn off calories taken in
• Withdrawal from usual friends and activities
• In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns

Anorexia nervosa involves self-starvation. The body is denied the essential nutrients it needs to function normally, so it is forced to slow down all of its processes to conserve energy. This slowing down can have serious medical consequences.

Health Consequences of Anorexia Nervosa:

• Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as heart rate and blood pressure levels sink lower and lower
• Reduction of bone density (osteoporosis), which results in dry, brittle bones
• Muscle loss and weakness
• Severe dehydration, which can result in kidney failure
• Fainting, fatigue, and overall weakness
• Dry hair and skin, hair loss is common
• Growth of a downy layer of hair called langue all over the body, including the face, in an effort to keep the body warm

Information provided by nationaleatingdisorders.org. 

Services are available to the campus community for Anorexia Nervosa at the WSU Counseling & Testing Center. For more information, call (316) 978-3440 or see their website at www.wichita.edu/counselingtesting.

Binge Eating Disorder

Binge Eating Disorder (BED) is a type of eating disorder not otherwise specified and is characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating. It is characterized by:

• Frequent episodes of eating large quantities of food in short periods of time
• Feeling out of control over eating behavior
• Feeling ashamed or disgusted by the behavior
• There are also several behavioral indicators of BED including eating when not hungry and eating in secret

Health Consequences of Binge Eating Disorder:

The health risks of BED are most commonly those associated with clinical obesity. Some of the potential health consequences of binge eating disorder include:

• High blood pressure
• High cholesterol levels
• Heart disease
• Diabetes mellitus
• Gallbladder disease

About Binge Eating Disorder:

The prevalence of BED is estimated to be approximately 1-5% of the general population.

Binge eating disorder affects women slightly more often than men--estimates indicate that about 60% of people struggling with binge eating disorder are female, 40% are male (NIH, 1993).

People who struggle with binge eating disorder can be of normal or heavier than average weight.

BED is often associated with symptoms of depression.

Information provided by nationaleatingdisorders.org.

Services are available to the campus community for Binge Eating Disorder at the WSU Counseling & Testing Center. For more information, call (316) 978-3440 or see their website at www.wichita.edu/counselingtesting.

Bulimia Nervosa

Bulimia Nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating. It has three primary symptoms:

• Regular intake of large amounts of food accompanied by a sense of loss of control over eating behavior.
• Regular use of inappropriate compensatory behaviors such as self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise.
• Extreme concern with body weight and shape.

Eating disorder specialists believe that the chance for recovery increases the earlier bulimia nervosa is detected. Therefore, it is important to be aware of some of the warning signs of bulimia nervosa. Not all of these warning signs need to be present for bulimia nervosa to be diagnosed.

Warning Signs of Bulimia Nervosa:

• Evidence of binge-eating, including disappearance of large amounts of food in short periods of time or the existence of wrappers and containers indicating the consumption of large amounts of food.
• Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics.
• Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury--the need to �‚� burn off �‚� calories taken in.
• Unusual swelling of the cheeks or jaw area.
• Calluses on the back of the hands and knuckles from self-induced vomiting.
• Discoloration or staining of the teeth.
• Creation of complex lifestyle schedules or rituals to make time for binge-and-purge sessions.
• Withdrawal from usual friends and activities.
• In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can impact the entire digestive system and purge behaviors can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions.

Health Consequences of Bulimia Nervosa:

• Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium, sodium and chloride from the body as a result of purging behaviors.
• Inflammation and possible rupture of the esophagus from frequent vomiting.
• Inflammation and possible rupture of the esophagus from frequent vomiting.
• Tooth decay and staining from stomach acids released during frequent vomiting.
• Chronic irregular bowel movements and constipation as a result of laxative abuse.
• Gastric rupture is an uncommon but possible side effect of binge eating.

Information provided by nationaleatingdisorders.org.

Services are available to the campus community for Bulimia Nervosa at the WSU Counseling & Testing Center. For more information, call (316) 978-3440 or see their website at www.wichita.edu/counselingtesting.

Alcohol and Other Drug Abuse

Alcohol abuse on college campuses is a serious problem and can even involve those who do not drink. The costs are staggering in terms of academic failure, vandalism, sexual assault, and other consequences. If you are concerned about a person's abuse of alcohol or other drugs, it is important to make a referral to the Behavioral Intervention Team so the problem can be evaluated and an appropriate intervention determined. Keep in mind that this may help the person you are concerned about be more successful in school or work, possibly stay in school or most importantly, stay alive.

SIGNS AND SYMPTOMS

Alcoholism, also known as alcohol dependence, is a disease that includes the following four symptoms:

• Craving - A strong need, or urge, to drink.
• Loss of control - Not being able to stop drinking once drinking has begun.
• Physical dependence - Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety after stopping drinking.
• Tolerance - The need to drink greater amounts of alcohol to get "high."

Warning Signals of Alcohol and Other Drug Abuse

There are many signs of alcohol and other drug use, abuse, and addiction. None of these signs alone are conclusive proof of alcohol or other drug problems. Other conditions could be responsible for unusual behavior, such as an illness or reaction to a legally prescribed drug. Any one or a combination of these could be cause for alarm and could signal problems in general, as well as a substance abuse problem:

• Impairment of Mental Alertness
  Lack of concentration, short-term memory loss, confusion, and inability to follow directions.
• Impairment of Mood
  Depression, extreme or unpredictable moods swing, flat or unresponsive behavior, hyperactivity, loss of interest in ones work/school results, nervousness, and volatility.
• Impairment of Motor Behavior
  Hand tremors, loss of balance, loss of coordination, staggering, inability to work normally, slurred speech, and passing out from alcohol or other drug use.
• Impairment of Interpersonal Relationships
  Detachment from or drastic change in social relationships, becoming a loner or becoming secretive, attempt to avoid friends or co-workers, loss of interest in appearance, change of friends, extreme change in interests, tendency to lose temper, being argumentative, or borrowing money and not repaying.
• Violation of University Rules, Impairment of Academic and Work Performance
  Inability to perform work assignments at usual level of competence; missed deadlines; missed appointments, classes, or meetings; increased absenteeism or lateness; frequent trips from assigned or expected work area; accidents in the lab; complaining or feeling ill as an excuse for poor performance; coming to class, practice, or work intoxicated/high; legal or judicial problems associated with alcohol or other drug use; not scheduling morning classes, neglected school or work obligations for two or more days in a row. (Some individuals with substance abuse problems are still able to perform at a high academic level.)

Information provided by factsontap.org. For additional information about substance abuse and dependence see their website: www.factsontap.org/

Services are available to the campus community for substance abuse and dependence at the WSU Counseling & Testing Center. For more information, call (316) 978-3440 or see their website at www.wichita.edu/counselingtesting.

The Manic Student

SIGNS

Symptoms of mania are part of a disorder called Bipolar Disorder. Persons with mania are characterized by having persistently lofty or irritable moods. Different from the normal ups and downs that everyone goes through, these symptoms are severe. They can result in damaged relationships, poor job or school performance, and even suicide.

SYMPTOMS

• They often see themselves in a grand light, sometimes believing that they are famous or that the work they are doing is awe-inspiring.
• They often are overly talkative, with rushed speech and racing thoughts.
• Typically, their high energy interferes with their sleep.
• They can be very irritable and overly involved in pleasurable activities, such as sex or spending money.

Generally, these persons are not dangerous, but caution should be taken, especially if alcohol or if other drugs are involved. If they try to put their rapid thoughts and words into action, they may place themselves in unsafe situations.

Signs and symptoms of mania (or a manic episode) include:

• Increased energy, activity, and restlessness
• Excessively "high," overly good, euphoric mood
• Extreme irritability
• Racing thoughts and talking very fast, jumping from one idea to another
• Distractibility, can't concentrate well
• Little sleep needed
• Unrealistic beliefs in one's abilities and powers
• Poor judgment
• Spending sprees
• A lasting period of behavior that is different from usual
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
• Provocative, intrusive, or aggressive behavior
• Denial that anything is wrong

Information provided by the National Institute of Mental Health. For additional information about depression see website at:
http://www.nimh.nih.gov/health/publications/bipolar-disorder/symptoms.shtml

Services are available to the campus community for Bipolar Disorder at the WSU Counseling & Testing Center. For more information, call (316) 978-3440 or see their website at www.wichita.edu/counselingtesting.