No one knows what was going through the mind of UC Santa Cruz Chancellor Denice Denton as she jumped off the 42nd floor of a San Francisco apartment building on June 24.

The only thing we can say for sure is that she suffered a profound failure of imagination, entrapped by the inability to envision a different way out. Chancellor Denton's death was tragic not only for her and for her family and friends, but for the university community that must now carry on in her absence. In the United States, suicide is among the top 10 causes of death for teens and adults under age 65. Though suicide can and does occur in mentally healthy people, most people who attempt suicide are clinically depressed.

Clinical depression has a lifetime prevalence approaching 20 percent. It is not the same thing as ordinary sadness or even the transient despondency that follows a breakup or death. Depression is marked by persistent sadness, inability to experience pleasure and interference with ordinary functioning. People with clinical depression describe a mental fog that robs them of energy, disrupts concentration, erases hope and precludes meaningful engagement with others. Symptoms last months, then gradually resolve, often recurring years later. Though depression is sometimes romanticized as a catalyst for artistic creativity, patients will tell you there is nothing romantic about it.

Second-generation antidepressants like Prozac boost levels of certain neurotransmitter chemicals in the brain, and in about 65 percent of cases patients on adequate doses of these medications start to feel better within two to four weeks. The improvement is palpable, but it is also visible using modern neuroimaging techniques. Cells within the depressed brain die, and parts of the brain actually shrink. Remarkably, the shrinkage can be interrupted and even reversed by antidepressants or by cognitive-behavior therapy, a form of psychotherapy that helps people assess how their view of the world, specifically their sense of self, environment and future, affects mood and vitality.

These insights from the clinic and the lab reinforce the modern view that depression occurs when a vulnerable brain encounters stress or loss beyond a threshold. It takes a combination of predisposition and circumstance to get depression going. Some people will spiral into the gloom with minimal provocation, while others will demonstrate remarkable resilience to the most cruelly aimed of fortune's slings and arrows. Once depression strikes, however, repeated episodes may be triggered by increasingly subtle environmental insults. Many psychiatrists now recommend that depression be treated early and aggressively.

Share of stressors

The university environment offers up its share of stressors. Students find themselves far from home and family. Some are challenged academically, others socially. Faculty and staff struggle to achieve balance between work and personal life. And administrators face their own pressures in an era of diminished resources and increased accountability.

The vulnerability-stress model of depression suggests some things we can do: maximize our resilience by getting plenty of rest, drink only in moderation, and take regular exercise; work on enriching our social networks; engage in planned pleasurable activities; and, when necessary, seek professional help. And when we see associates who are sad, who don't enjoy things they used to like doing, or who just aren't themselves, we need to get them to seek help, too.

Institutions can play a role in fighting depression by providing services and raising awareness. At UC Davis, student demand for mental health services has grown rapidly, and staffing for psychologists and psychiatrists at Counseling and Psychological Services needs to grow apace. CAPS workshops for faculty and staff on "distressed and distressing" students deserve broader play, and the Academic Staff Assistance Program should be better publicized. The campus would also benefit from a campaign to raise awareness that depression is a real but highly treatable condition.

Depression is no laughing matter. But it is also no cause for despair. UC Davis should use the tragedy of Chancellor Denton's death to reinvigorate its own fight against depression. In the meantime, take notice of your colleagues and students. Encourage them to seek help at ASAP or CAPS if you think they may be depressed. A campus community of care will go a long way towards keeping UC Davis mentally healthy.

Richard Kravitz is a professor of internal medicine.