Signs of Distress and How to Help

Listed below are some of the more prevalent signs of someone in distress. This list is intended to provide basic information only.

1. Depression: While we all may feel depressed from time to time, "normal" depressions may consist of only one or two symptoms and usually pass within days. Clinically depressed students will exhibit multiple symptoms for a longer period of time. Some of these symptoms are sleep disturbances, poor concentration, change in appetite, loss of interest in pleasurable activities, withdrawal, poor hygiene, loss of self-esteem, and preoccupation with death.
2. Agitation or Acting Out: This would represent a departure from normal or socially appropriate behavior. It might include being disruptive, restlessness, or hyperactivity, being antagonistic, and increase alcohol and/or drug abuse.
3. Disorientation: Some distressed students may seem "out of it." You may witness a diminishment in awareness of what is going on around them, forgetting or losing things, misperception of facts or reality, rambling or disconnected speech, and behavior that seems out of context or bizarre.
4. Drug and Alcohol Abuse: Signs of intoxication during class or interaction with University officials are indicative of a problem that requires attention.
5. Suicidal Thoughts: Most people who attempt suicide communicate early messages about their distress. These messages can range from "I don't want to be here", to a series of vague "good-byes", to "I'm going to kill myself." Non-verbal messages could include giving away valued items, and putting legal financial, and University affairs in order. All of the above messages should be taken seriously.
6. Violence and Aggression: You may become aware of students who may be dangerous to others. This may be manifested by physically violent behavior, verbal threats, threatening e-mail or letters, harassing or stalking behavior, and papers or exams that contain violent or threatening material.

Additional signs may include:

• Increased nervousness, agitation, or irritability
• Withdrawal from others (isolation)
• Sudden changes in academic performance
• Sudden changes in personal or classroom relationships
• Undue aggressive or abrasive behavior
• Infrequent class attendance
• Marked change in personal hygiene
• Fearfulness
• Dependency (e.g., the student who always hangs around you or constantly tries to see you)
• Confusion - including bizarre, alarming, or dangerous behaviors

If you have decided to approach a student or if a student reaches out to you for help, here are some suggestions that might be useful.

• Talk to the student when both of you have time and are not rushed.
• Listen to thoughts and feelings in a sensitive, non-threatening way.
• Express your concern in specific nonjudgmental terms that reflect your concern for the well being of the student.
• Let the student know that you believe a consultation with a staff member at the Counseling Center could be helpful. If the student becomes defensive, simply restate your concerns and recommendations.

For various reasons, students are sometimes reluctant to see a counselor. If a student is reluctant, taking the following steps can help to ease some of the anxiety about counseling that a person may feel.

• Assure the student that counseling is confidential and does not go on their academic record.
• Assure the student that asking for help is a sign of strength rather than weakness.
• Sometimes the student feels that his/her problem is too small to bother a counselor with. Assure the student that counselors meet with students on all kinds of concerns - large and small.
• Reluctant students are relieved to know that they can meet with a counselor on a one-time basis. There may not be the need to meet with a counselor over an extended period of time or the student may choose to meet with a counselor only once. For students who seem interested but reluctant to go for counseling, a helpful strategy might be to suggest that they try it one time to see how it goes.

When a student needs to be seen right away, we make every effort to see them as soon as possible. Call and communicate with the receptionist that there is a student who is interested in coming for counseling and needs to be seen right away. If the student makes the appointment in your presence it is important that we know the urgency and specifics of the situation. Speak with a counselor about your referral and provide the counselor with a description of the situation that has led to your concern.

While it is important to be helpful to others, we cannot make their decisions for them, and counseling should always be a personal choice. Occasionally even your best efforts to encourage a student to seek counseling will be unsuccessful. If the student resists referral and you remain uncomfortable with the situation, contact your department chair, the Counseling Center, and/or the Dean of Students.

While it is not expected that you be a "watchdog" or that you provide a thorough assessment, you may be the first contact for a student in distress and in a position to ask a few questions. Following these guidelines can lead to a positive outcome for all parties.

1. Safety First! Always keep safety in mind as you interact with a distressed student. Maintain a safe distance and a route of escape should you need it. If danger to you or the student seems imminent, call 911 or the OU Police at (248) 370-3333.
2. Avoid Escalation: Distressed students can sometimes be easily provoked. Avoid threatening, humiliating, and intimidating responses. It is usually not a good idea to "pull rank" and assert authority unless you are certain of the student's mental health status. Distressed students are in need of listening, validation, and support. One can always remind them of rules at a later time.
3. Ask Direct Questions: Take a calm and matter-of-fact approach. Ask students directly if they are drunk, confused or if they have thought of harming themselves. You need not be afraid to ask these questions. You will not be "putting ideas in their heads" by doing so. Most distressed students are relieved to know that someone has noticed and is paying attention.
4. Do Not Assume You Are Being Manipulated: While it is true that some students appear distressed in order to get attention or relief from responsibility, only a thorough assessment can determine this. Attention-seekers can have serious problems and be in danger, too.
5. Know Your Limits: You will be able to assist many distressed students on your own by simply listening and referring them for further help. Some students will, however, need much more than you can provide. Respect any feelings of discomfort you may have and focus on getting them the assistance they require. You can do this by reinforcing them for confiding in you, being accepting and nonjudgmental, trying to identify the problem area, and indicating that seeking professional help is a positive and responsible thing to do that takes a lot of strength and courage.

Some signs that you may have overextended yourself include:

• Feeling stressed out of overwhelmed by the situation
• Feeling angry at the student
• Feeling afraid
• Having thoughts of "adopting" or otherwise rescuing the student
• "Reliving" similar experiences of your own