Lebanese University Researchers Zero In on Students’ Stress and Depression

It’s an inescapable truism of student life that exams are stressful, but new research from the Lebanese University has now measured the biological effects of that stress on the body. The research also shows that students don’t get better at coping with stress—final-year students feel just as much pressure during exams as the less experienced freshmen.

A second study, also from the Lebanese University, has detailed the high prevalence of depression among medical students and the disorder’s correlation with Facebook use.

Together, the two studies highlight the need for students to be more aware of the risks to mental health they face and to take steps to manage them, scientists involved in the studies say.(See a related article, “Tips for Students: How to Cope with Exam Stress.”)

“We found that students aren’t good judges of whether they’re stressed or not,” says Mazen Kurdi, a professor of biochemistry at the Lebanese University. “Which I think shows the need for everyone to be more aware of stress whether they think they’re stressed or not.”

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Kurdi and his team fitted a small patch on the chests of 90 students one hour before they were about to sit for an exam. The study sample was made up of 60 female students and 30 male students. The device measured heart-rate variability before, during and after the students took the test.

“It can be difficult to measure stress,” says Kurdi, “but heart-rate variability is one way. We’re measuring factors that put stress on the heart. Stress is after all a significant factor for cardiovascular disease.”

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Individual bouts of stress, such as taking an exam, every now and then are not sufficient to cause any long-lasting health problems. However, the lead-up to an exam is often a stressful experience too—one that can be sustained over several months and which occurs at least once a year throughout a university student’s life. This means it’s important for students to take steps to manage that stress.

Perhaps unsurprisingly, Kurdi found that students were under the most strain during and before their exams. Their heart rates then showed signs of returning to normal once the test was over.

“We compared students by their year of study because we thought the students might adapt to the stress,” he says.

But the results didn’t show that.

Regardless of their year of study, the students suffered a similar amount of stress. That suggests that they aren’t learning coping mechanisms, says Kurdi. “Stress is still stress, and that doesn’t seem to change as students progress through their studies.”

The study also had a self-assessment component. Kurdi asked students to estimate whether they felt physically stressed or not. Those who said they didn’t feel tense were a bad judge of their own state because they showed levels of stress, as measured by heart-rate variability, similar to those of individuals who admitted to feeling uncomfortably pressured.

“Students really weren’t good at telling if they were stressed or not,” says Kurdi. That highlights the need for people to be more aware of themselves in stressful experiences and not assume that they’re OK—they shouldn’t ignore the possibility of stress, he says. “It shows they all need to think carefully about how to help themselves.”

Depression and Medical Students

A second survey-based study looked at the rate of depression among 340 medical students at the Lebanese University and also asked questions about their Facebook use.

“Stress is linked to depression,” says Ramzi Haddad, a study author and professor in the Lebanese University’s department of psychiatry. “Medical studies are extremely stressful and depression among medical students is not rare. That’s why we looked at medical students.”

Haddad and his colleagues used a well-known academic survey to estimate how depressed a participant might be. The survey does not provide a full diagnosis, but it gives enough detail for research purposes. The survey asks participants how many days a week they experience certain scenarios such as a lack of appetite, trouble concentrating, or thoughts of suicide and self-harm.

Based on participants’ answers, the survey places them into one of five groups, ranging from no signs of depression up to scores suggesting severe depression. Close to 35 percent of the students were ranked as showing between mild to severe signs of depression. (See a related article, “Study to Map Mental-Health Needs of Lebanese Youth.”)

The same students completed a second survey that asked about how often they use Facebook.

“The results show depression and Facebook use are correlated,” says Haddad. “That’s not to say Facebook is causing this trend, it’s just an association.”

While many people have long theorized that social media triggers depression by causing a fear of missing out, the evidence is spotty. Haddad says Facebook could in fact be a positive force for those at risk of depression.

Depressed people often shun face-to-face interactions, so Facebook could be one of the only means by which they’re getting any sort of social interaction, he explains. “That doesn’t mean Facebook is a treatment—that’s not at all what I’m saying. But maybe it’s better than a total absence. Essentially, it’s better than nothing, which is sometimes the alternative.”

That’s one way, says Haddad, to explain the statistically significant association between Facebook use and risk of depression.

His colleagues agree.

“It’s still a problem if people are only communicating via social media, but at least it’s something,” says Wadih Naja, a professor of psychiatry at the Lebanese University who collaborated with Haddad on the study.

Additionally, Naja says the study’s findings suggest that Facebook could be used to actively help people with mental health needs. If mental healthcare experts know that depressed people are more likely to use Facebook than people who aren’t depressed, then they know Facebook is one platform to reach them on, he says. (See a related article, “Social Media Can Fight the Arab Health Crisis.”)

“It’s a good place to run awareness campaigns, send key messaging and publish articles,” he says. “To make people more aware of the help that exists and encourage them to seek it.”