Spotlight: Mental health treatment Option three

Background to major depressive disorder is Catatonia, delusions, destruction, disorder. Cognitive therapy which was established by cognitive behavioral therapy Beck et al. Antidepressants most commonly prescribe are ADMs.

Supports my perspective

I believe that the best treatment is a combination of antidepressants and cognitive therapy. While the patient is learning to cope mechanisms, and learning reframing techniques they still have the antidepressants to fall back on. There is a large amount of data that antidepressants treat moderate to severe depression. There is less data on cognitive therapy. The objective is to compare the efficacy is moderate to severe depression of antidepressant medications with cognitive therapy in a placebo controlled trial. The design is 16 weeks of cognitive therapy, 16 weeks of medication, and 8 weeks of pill placebo. The Hamilton Depression Rating Scale provided continuous severity scores. At week 8 50% of the medication and 43% groups were superior to placebo. At the end of the study cognitive therapy was just as effective as medications. Some limitations are the quality of the therapists. The Treatment of Depression Collaborative Research Program Compared cognitive therapy and Antidepressants and no differenced were observed between cognitive therapy and antidepressant patients.

For Antidepressants

The National institute of mental health first recommends antidepressants as treatment for major depressive disorder.  Antidepressants alter the way the patient’s brain uses chemicals, so it is more efficient.  The national institute of health leans towards these methods because they have empirical evidence of neurotransmitters. The National institute for metal health also discusses cognitive therapy but as a second option to antidepressants.

The in the national revision of neuroscience 2008 by the National institute of health. Patients are advised to take ADM for at least six months to prevent relapse. In the patient does not experience symptoms then they are said to be cured if they do have symptoms then they are prescribed antidepressants indeterminately. These patients are deemed to have chronic depression. The efficiency of ADMs has been established in “thousands of placebos controlled clinical trials.” ADMs seem to be symptom suppressive instead of curative.  Lots of studies have shown that ADMs change the regulatory processes of the monoamine systems. Some negative effects are changes in sleeping, appetite sexual interest, and emotional response.

 

For cognitive therapy

In the United Kingdom’s National Health Service it is stated that cognitive therapy is as effective as antidepressants and therefore recommends cognitive therapy first. The antidepressants simply suppressed the side effects while the cognitive therapy got to the root of the problem and cure the problem. This study was carried out by the University of North Carolina International and Danube University. Then peer reviewed by the British medical journal.  Some limitations are this is only for moderate depression some doctors think that severe depression need to be treated with antidepressants first.

The Time magazine used a PET scan to see the brain function when researchers took scans. The participants who got well had increased insula this is a region that assesses or signals pain.  The pattern of insula levels predicted who would respond better to talk therapy or antidepressants. Those who responded best to talk therapy tended to have reduced insula compared to before.  Cognitive therapy teaches the patients what their thoughts mean and teaches them coping techniques therefore is advised.

References

@maiasz, M. S. (2013, June 17). Talk Therapy or Antidepressant? A Brain Scan Predicts Which Works Best for Your Depression. Retrieved December 07, 2017, from http://healthland.time.com/2013/06/17/talk-therapy-or-antidepressant-a-brain-scan-predicts-which-works-best-for-your-depression/

Depression. (n.d.). Retrieved December 07, 2017, from https://www.nimh.nih.gov/health/topics/depression/index.shtml

DeRubeis, R. J., Siegle, G. J., & Hollon, S. D. (2008, October). Cognitive therapy vs. medications for depression: Treatment outcomes and neural mechanisms. Retrieved December 07, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2748674/

Http://ljournal.ru/wp-content/uploads/2017/03/a-2017-023.pdf. (2017). doi:10.18411/a-2017-023

Talking therapy ‘as effective as antidepressants’ study finds. (n.d.). Retrieved December 07, 2017, from https://www.nhs.uk/news/mental-health/talking-therapy-as-effective-as-antidepressants-study-finds/

 


Medication or Psychotherapy? Why Not Both?

Although collectively many sources believe that the most effective way to treat a mental health condition is to use both medication and psychotherapy, a comparison of the argument of which is better shows a slight preference for psychotherapy over medication.

Those who support psychotherapy as treatment for a mental health condition suggest that the strengths of psychotherapy lie in its long-lasting results and variety of different treatments based off of the brain. Psychotherapy is able to have long-lasting effects on a person as he or she is regularly being taught coping skills that can be utilized outside of therapy sessions to help treat his or her mental conditions (Andersson). By teaching these coping skills, the person is learning how to identify the problem causing discomfort in his or her life and can take positive action in fixing those problems, replacing negative thoughts and influences in the process. This can also help in the case of a mental health condition getting better, but then worsening in the future, as the person will already have the knowledge and skill in improving their mental health to help solve the issue again (Andersson).

As well, another specific strength supports of psychotherapy suggest is that of variety. As psychotherapy focuses on different aspects of the brain that can be utilized to dig out problems and resolve them, it is suggested that psychotherapy therefore has more options and potential in solving mental health issues (American Psychiatric Association). What is suggested here is that people can save time from treatments that are ineffective with psychotherapy as their differing brain states can be more specifically tailored in s psychotherapy treatment than a medical treatment (American Psychiatric Association).

Supporters of psychotherapy are also quick to point out the many downsides to use medication as treatment for mental conditions. Psychotherapy is not considered to have any negative side effects and is not considered to be addictive, however many medications are (Andersson). In fact, many people fear taking medication as a solution to their mental condition due to a fear of reliance on the drug that the drug may change some aspect of their personality or identity (American Psychiatric Association). In a study where researchers did a meta–analysis of rates of treatment refusal and rates of drop out for psychotherapy and medication, the researchers found that out of the eight percent that refused treatment and the twenty-two percent that dropped out of treatment, the majority of those people were using medication and not psychotherapy (American Psychiatric Association).

However, this does not mean that medication as treatment for mental health conditions does not also have support. Many supporters of medication over psychotherapy suggest that the strengths of medication lie in its quicker, short term resolution of the problem and its tendency to cost less than psychotherapy. In regards to medication being a quicker and more short-term resolution to mental health conditions, this can be seen as a positive as some conditions may have severe symptoms that need to be dealt with immediately to ensure the safety of the person (Association for Behavioral and Cognitive Therapies).

Similarly, medication that is often prescribed as treatment for mental health conditions is seen as less expensive. Not only is the medication prescribed once, meaning a person pays once instead of multiple times, such as for sessions in psychotherapy, but often times a person’s insurance will cover the cost of the medication while a person’s insurance may only cover a limited amount or none of psychotherapy (“Psychotherapy or Medication”). If the treatment is more affordable, this may affect the person’s willingness to stay with the treatment and how he or she perceives the treatment is going.

As for the reliability for these sources, I would say that they are fairly reliable as the Center for Treatment of Anxiety and Mood Disorders, the American Psychiatric Association, the World Psychiatric Association, and the Association for Behavioral and Cognitive Therapies are all official psychological organizations. The most reliable source can be considered the source from the World Psychiatric Association as that journal was included in the U.S. National Library of Medicine and was the only source that included their randomized sample, measurement process, and experimental process and design in order to ensure that the information they said could be generalized and reliable.

Yet, this is not to say that my opinions on medication and psychotherapy have changed. Although a comparison of support for psychotherapy and a support for medication shows that psychotherapy has slightly more support due to the downsides of medication, I still believe that the use of both is most effective in improving mental health conditions. Each mental health condition is unique; therefore some situations may cause for temporary medication to be used in order to effective act out psychotherapy, or vice versa. All options should be kept open, as long as the overall mental health conditions of individuals in the world are improving.

 

References:

American Psychiatric Association. “Treating Depression – Psychotherapy or Medication?” American Psychiatric Association, American Psychiatric Association, 17 Apr. 2017, http://www.psychiatry.org/news-room/apa-blogs/apa-blog/2017/04/treating-depression-psychotherapy-or-medication.

Andersson, Gerhard, Beekman, Aartjan T., Cuijpers, Pim, Koole, Sander L., Reynold, Charles F., Sijbrandij, Marit. “The Efficacy of Psychotherapy and Pharmacotherapy in Treating Depressive and Anxiety Disorders: a Meta-Analysis of Direct Comparisons.” U.S. National Library of Medicine, Blackwell Publishing Ltd, 4 June 2013, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3683266/.

Association for Behavioral and Cognitive Therapies. “Treament Opitions: CBT Or Medication?” Association for Behavioral and Cognitive Therapies, Association for Behavioral and Cognitive Therapies, http://www.abct.org/Help/?m=mFindHelp&fa=CBT_Or_Medication.

“Psychotherapy or Medication – Which Should You Choose?” The Center for Treatment of Anxiety and Mood Disorders, The Center for Treatment of Anxiety and Mood Disorders, 6 Apr. 2017, http://www.centerforanxietydisorders.com/choose-psychotherapy-medication/.


Spotlight Blog 3 Mental Health Treatment

Psychotherapy can assist in treating Major Depressive Disorder by easing stress and giving the patient the chance to talk with a professional about their problems with depression on a deeper level. WebMD gives a great perspective on how Psychotherapy can assist someone struggling with depression cope and get better over time; especially when the depression is not very severe, but severe enough that therapy is found necessary. It discusses the ways therapy can give support and advice a person needs to benefit someone struggling with this common mental illness. Psychotherapy helps patients find ways to deal with medication symptoms, making it arguable compared to taking medication due to the fact that their is no side effects; it in fact helps cope with symptoms and help pull apart the deeper meaning of why a person might be struggling with depression.

The Cleveland Clinic also breaks down how Psychotherapy can assist those with depression by becoming more educated about problems in their lives as well as regaining control in their lives. It is hard for people with depression to feel like their life is in their hands. Lots of patients feel like they do not have the correct authority over what happens in life and the choices they make. It is important to have these skills that some can only gain by going to therapy and talking about their problems with trained professionals. This is especially necessary when the patient is unsure on how to go about solving these problems; as Psychotherapy can lead them down the right path mentally without medication that can also affect a person physically. The Cleveland Clinic also states that Psychotherapy attacks depression at the root of the problem and is not just a quick fix like medication is. It is also the treatment that has little relapse compared to medications, this way patients are less likely to relapse and fall back into their depression.

PSYCOM writer, Katie Hurley, breaks down how medication is used to treat depression through antidepressants. It is also initially stated that medication works best when used hand in hand with Psychotherapy to treat depression and is in fact most commonly used this way. There are several types of antidepressants that all come with different possible side effects and symptoms. Most antidepressants, especially for teens simply raise the amount of serotonin in the body, allowing a patient to feel in control and happy with their life again. Medications also give instant results that include mood and focus improvement as well as take away “depressive symptoms that cause suicidal thoughts” (Hurley 1). Although this statement is a bit confusing due to the fact that most risks of antidepressants are commonly suicide. There is also risks of sexual side effects, dizziness, and insomnia. These symptoms can last throughout the period of time the patient is taking the medication or could even last a possible lifetime. Although some of these risks are extreme, it is worth the uncertainty to patients with depression who need a quick and effective fix to get back to a normal life.

PubMed Health talks about how antidepressants make chemicals in the brain such as serotonin, which is believed to control nerve connections in the brain; ultimately causing Major Depressive Disorder. I loved the way this source explains the way one goes about taking an antidepressant after accepting the possible symptoms. PubMed Health has a great outlook on how these medications work, and how once a patient is prescribed them, they should be gradually weened off over time since the symptoms can be so negative. It also goes into how medications can relieve symptoms, and how well medications work while fighting against severe depression, but is not as effective while treating moderate to mild depression. Another part of taking medications is their a stereotype that a patient is more likely to relapse, where in reality, these are the people that have chronic depression or have had several relapses in the past. This article made it very clear that anti depression medications have serious side effects, but also help people with severe depression get back in control of their lives.

 

 

 

https://www.webmd.com/depression/guide/treatment-resistant-depression-psychotherapy#1

https://my.clevelandclinic.org/health/articles/psychotherapy-for-depression

https://www.psycom.net/depression.central.teens.medication.html

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0087089/


Spotlight Blog 3- Option 3

There is a lot of controversy over whether medication or therapy is better when  seeking treatment for a mental health condition. Major depressive disorder is the most common mental health condition in the U.S. and can be treated with either medication or psychotherapy. There are many reasons why each of these treatments are better than the other. Psychotherapy is a talk therapy that allows the client to speak with a professional about how they feel, which is great for people with major depressive disorder because it makes them feel heard and they are able to be given coping mechanisms from the therapist based on what they tell the therapist. Psychotherapy is not categorized as one thing, there are many different kinds of psychotherapy that the therapist would be able to decide what technique they would use based on the client. All types of psychotherapy teach individuals about depression, help the client understand, express and control their feelings more effectively, and transform their negative feelings to be more positive and uplifting.

There are many traits that make up a good therapist;

sophisticated, builds trust, acceptable, influential, optimistic, reflective, and hopeful.

By having a therapist with these traits, the use of psychotherapy as treatment is better than medication because it is more cost effective and leads to less relapse. In a study performed by Boadie W. Dunlop, M.D., people with depression were more likely to refuse medication than to refuse psychotherapy, and those who were treated with medication were more likely to drop out of treatment earlier than those who were being treated with psychotherapy.

There are a lot of people who do believe that medication is a better alternative to treating major depressive disorder. Kathryn McHugh did an investigation of the McLean hospital where she discovered the majority of patients preferred medicinal treatment over psychological treatment.  It has been proven that medication will help relieve depression, but it is difficult to prove that psychotherapy can do the same thing. Although psychotherapy has been deemed evidence-based, people find it hard to believe that this is true and trusting the studies that prove this, which is why many people still prefer medication over psychotherapy.

It was very difficult to find articles about why medication is more effective than psychotherapy when used for mental illnesses and I think this is because many people are now looking for the healthiest and most effective way to get help. I think that many people are afraid of medication and are aware of all the harm it can do. Psychotherapy is a healthier and safer way to get help for mental illnesses because it doesn’t come with side effects or a list of dangers, it’s a client telling the therapist how they feel and being able to confide in someone they trust and getting support and coping strategies that are healthy and helpful specifically for them that can be changed according to the specific client at any time.

Psychotherapy

Psychotherapy is effective

Psychotherapy vs. depression

Medication vs. Psychotherapy

Medication


Spotlight Blog 3

For this spotlight blog I chose to do the third option about psychotherapy versus medication for treatment of major depressive disorder. Finding different articles was quite easy since this is a very prominent topic in todays society. For the most part, the articles were debating back and forth about the pros and cons of each type of treatment. For the most part I found that there are more articles that lean more toward the use of psychotherapy as treatment. Most say that medication will help in short term but psychotherapy is more long lasting.

The first article in favor of psychotherapy treatment talks about how over the years psychology has become a more rigorously tested science which has led to the evidence behind the effectiveness of this treatment. According to this article, there was a study that cognitive therapy was just as effective as antidepressants when dealing with chronic depression. Doctors have seen people make bigger strides with just the use of therapy. Slowly, doctors are starting to realize that the first line of treatment recommended should be behavioral strategies and not medication. Theres no reason for people to have excuses to not go to therapy because insurance companies now cover it since it is the treatment for a mental condition.

https://www.forbes.com/sites/alicegwalton/2016/05/06/a-few-things-that-therapy-may-do-better-than-medication-according-to-science/#7bd6dd344243

The second article I found talks about other types of treatment but the little parts about psychotherapy and medication stand out. The article says that medication can be used but all it does is treat the chemical aspect of everything and it doesn’t do anything for the underlying causes of the depression. It also says how antidepressants come with side effects and safety concerns. In comparison, it says how psychotherapy helps you understand the underlying causes and how to deal with them. It can help you deal with your relationships with others as well as help you reduce stressors in you life or at work or school that will only serve to worsen your depression.

https://www.helpguide.org/articles/depression/depression-treatment.htm

The first article I found in favor of medication talked about all the symptoms that will be relieved with the help of different medications. This article says that medications can help get rid of symptoms like anxiety, restlessness, and suicidal thoughts and stop them from every coming back. Though they may not be as beneficial for mild cases of depression, they’re very effective for very severe cases and can help prevent relapses for many people.

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0087089/

The second article for medication talked about how medication plays a crucial role in the treatment of depression. It said how medication is very important for people with chronic and long term symptoms. According to the article, a certain kind of antidepressant is proven to consistently reduce symptoms by 30-60%.

http://www.bhevolution.org/public/medications.page

I though that it was near impossible to find articles that were in favor of medication over psychotherapy. There are just too many side effects and dangerous aspects to it. I believe that psychotherapy is the way to go even though it may take sometime to get better. It confronts the underlying reasons for depression and how to deal them and I believe that’s the only way to improve. By handling that, I think that this in turn will improve the symptoms that medication is said to get rid of.

 


Spotlight Post #3

For my Spotlight #3 Post, I’m choosing to write about the effectiveness of psychotherapy versus the use of medications to treat major depressive disorder. I found a lot of different articles that gave good arguments for both sides. One article written on WebMD titled “Talk Therapy vs Meds for Major Depression,” mentioned that many studies showed that patients were equally helped by both forms of treatment, however, people mentioned that patients are a lot less likely to go for psychotherapy unless it was suggested by their doctor. So while it was shown that people were equally helped by both forms of treatment, more people choose to take medication because that is the form that is suggested by their doctor more often. Another article I read came from the Mayo Clinic. It also said that both forms of treatment are effective, and also listed some cons of taking medications. It said that taking anti-depressants can cause physical dependence to the medication so if the patient stops taking their medication for any reason, they can experience withdrawal-like symptoms and their depression could worsen. Another potential risk to young adults is increased suicidal thoughts while taking anti-depressant medications; it is usually a result of a changed dosage. While medications can help with physiological problems like serotonin imbalances, psychotherapy can helps with a patient’s behavior. It can turn a behavior that is negatively affecting the person’s depression and redirect them into a positive behavior. Another article that I read titled, “Psychotherapy vs. Medications: The Verdict Is In,” was definitely advocating more for the use of psychotherapy than for antidepressants. They gave support for their argument by citing all the potentially harmful side effects, including how it is possible for people to overdose on their medication if taken with alcohol. The next article that I read gave some pros and cons of medication versus psychotherapy. The article gave a few reasons that people normally choose antidepressants over psychotherapy. One reason was that people usually see faster results from taking medication over going to therapy; it can take six to eight weeks longer for someone to start to see positive results. Also, psychotherapy alone is not usually enough to treat someone that has severe depression so medications are usually required. As far as credibility, I think the articles from WebMD and the Mayo Clinic are credible sources. They cite information taken from academic journals to back up their claims. As far as the last two articles go, I do not think they are as credible as the first two. It does not mean that the information that they are giving necessarily is wrong, the pages just have not been reviewed by medical professionals. I personally believe that people should try psychotherapy before they decide to take antidepressants because they could potentially be helped without adding chemicals to their body. I am not a fan of taking medications, or even getting vaccines because sometimes I think doctors go overboard with prescribing medications, especially when there is potentially another treatment that could be effective in helping their patient. I do not think it is always healthy to add all the extra chemicals to your body unless it is necessary.

 

References

https://www.webmd.com/depression/news/20151208/talk-therapy-antidepressants-offer-similar-results-for-major-depression#1

https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013

https://www.psychologytoday.com/blog/fulfillment-any-age/201507/psychotherapy-vs-medications-the-verdict-is-in

http://www.healthcommunities.com/depression/psychotherapy-for-depression-and-bipolar-disorder_jhmwp.shtml


Spotlight 3 Prompt 3

Psychotherapy: http://www.apa.org/monitor/2011/10/psychotherapy.aspx

http://www.washingtonpost.com/wp-dyn/content/article/2008/09/30/AR2008093001832.html

Most of the articles I found on the benefits of pyschotherapy over medication tended to have a very similar overarching theme; pyschotherapy is more effective in the long run. While medication can help short term, it isn’t going to get rid of the problem, it will push it under the radar (so to speak) for the duration of the medications effects. According to the washington post article, however, it would be best used for people with chronic mental illness who have been struggling for a long time. In the article by the APA, they stated that psychotherapy tends to have fewer relapses than medication, I think predictably as like I said, medications aren’t going to stay in the system forever. On the downside is the amount of time it takes, medications will give instant but short lived gratification, therapy is going to take a long time to take effect, but in the long run it has been shown to do the most good for people struggling with mental disorders. I definitely trust these sources, the APA being an authority on psychology, I should hope would be trustworthy. The Washington Post I also believe to be a reliable source, they are a well respected company with a reputation to keep, and to spread misinformation would harm that.

 

Medication: https://www.psychiatry.org/news-room/apa-blogs/apa-blog/2017/04/treating-depression-psychotherapy-or-medication

According to this article a study was done to test the effectiveness of cognitive-behavioral therapy and medication in patients with depression of varying severity. The conclusion it came to is that, depending on a patients “brain state”, the person will either benefit from therapy or medication, but not much from the other. Either way it definitely demonstrated that medication has the potential to be a much more potent solution to depression in some cases.

http://www.bhevolution.org/public/medications.page

The most important bit of information I saw in this article was the claim that medication is essentially necessary for the more severe forms of things like depression. It was conceded that therapy might be helpful for mild problems, but it would hardly be effective in worse cases.

 

My Opinion: I can easily say therapy is going to be the better choice in most cases. Finding reliable articles that were for medication was near impossible, most searches I did found me articles arguing against medication, and showing therapy becoming more and more popular due to all the side effects of medication and the possible inconsistency of it. My view is that slow and steady wins the race, therapy might take a lot longer than medication but the effects seem to be more permanent, with less risk of relapse which is a fair trade to me.


1st Impression Post- Mental Health Treatment

For this week’s first impression post I chose to do option two which looked at Michelle Obama’s mental health awareness campaign. The webpage has a really nice design and plenty of options to choose from, but as far as its effectiveness, I am not too sure. Yeah, its nice to have websites like these out there, and yeah it may be helpful for some, but a lot of people that have mental health problems do not want to admit they need help. So the people that really need the help most likely will not go looking for this webpage to find it. They will most likely go to people they care about. I do not think this campaign is bad; I think there should definitely be more awareness about mental health because there shouldn’t be a stigma around it like there is now. If the campaign helps one person who is in need of help, then I think that it should be a campaign worth keeping. It shows different ways that people are reaching out to bring awareness, and it has a page that is devoted to people pledging to know the five signs of emotional suffering and to change the culture surrounding mental health, mental illness, and wellness. You can make the pledge as just a single person or you can sign it with more people as part of a group. Overall, I think it is a good start for the campaign, but I think they have a lot more to do to bring awareness to many more people.


First Impression: Mental Health Treatment

The Change Direction campaign will be effective so long as its principles are shared with students by schools, classes, and youth organizations. I think the benefit of these resources can only be had if there is effort put into getting its message to young people. In the “about” section of the campaign site, it says that many private sector companies and nonprofits are sharing this information about mental health, to reduce the stigma surrounding it. A strength of the program is that it discusses the “5 Signs” of emotional suffering: personality change, agitation, withdrawal, decline in personal care, and hopelessness. These are all important markers to look out for, as these changes from what is deemed normal behavior can actually indicate a serious emotional issue, even we react passively to them. What it would take for the campaign to be effective would be if it is able to make this information known to young people so that they will remember these things when they start to notice change in themselves or in others. Another strength to the campaign is that it has the support of major companies associated with health, social work, and psychology.

The difficulty in successfully implementing the Change Direction initiative is getting students to listen. I believe at the high school level and below it will be very hard to get a good response from students. At the college level, I believe it would be far better received, as every college student is bound to be under incredible stress, whether it’s because they’re away from home, struggling to make friends, or crumbling under immensely challenging coursework. At Elizabethtown, I strongly believe an awareness campaign would be taken seriously by students and publicized well. To go about this, I think flyers are the simplest way of reaching students. However, I think the most profound method would be for professors to bring up things like mental health and the 5 Signs to students, as they are mostly already inclined to give their professor their full attention. Most of all, I think it’s important to stress the availability of Etown’s counseling services. Etown has great resources for anyone struggling with mental health or anyone trying to help a friend.


Week 15 First Impression: Option 2

At all points in life, you can never really know what someone is going through or dealing with. Mental illness can be sneaky like that. Someone seems fine on the outside but is really struggling on the inside. Thankfully, there are many organizations working to help people with mental illnesses get healthy again. One of those is Change Direction, a campaign supported by Michelle Obama. Their website shows some ways for people to keep good mental health, signs that someone may have a mental illness, what to do if someone is suffering, and some public service announcement videos. I think the campaign has a good chance to be successful. They give out clear, easy to follow steps for people to take in order to improve their mental health. They explain possible signs of a mental illness really well. In my opinion, the most important information they give are the ways to help those dealing with mental illness. A really close friend of mine at home was dealing with mental illness at one point. Along with the feeling of worry about my friend, there was this other feeling of having no idea what to do. They’re better now but at the time it was an awful feeling. Those tips would have gone a long way. I think the only real weakness of the campaign is that a lot of this is done on your own. I could see people checking in on themselves or others and just saying, “Oh, I’m fine” or “Oh, they’re fine” because they might be afraid of what it means if everything is not okay. Some college students will pay attention to this and some won’t. A lot of times, students just try to push through until they get a mental break. It’s not really healthy at all but with everything else you need to do in college it gets the job done. I think if Etown was to do a mental health campaign, they should model it after Change Direction. It would help the people who really need it.