The willowy blond who spent four months with six other twentysomethings in a Chicago apartment for MTV's soap-operatic The Real World says that having her life watched by 7-million viewers may not have been the smartest move for someone dealing with depression.
Yet many of the college students gathered in a University of South Florida lecture hall came first to see Cara Kahn, then learn about mental health.
"I've been on stages before, usually acting or singing. I didn't imagine being onstage talking about something so serious," Kahn, 23, said.
Kahn was at USF for the second stop in a 10-city college tour called "Depression in College: Real World, Real Life, Real Issues." Three mental health experts joined Kahn onstage Friday to tell students to get help if sadness stops their engagement in college's classes and social life.
Kahn, in a jeans jacket and with her long wavy tresses, made the message, um, real.
Diagnosed with clinical depression when she was a sophomore in high school and after her mother saw her becoming increasingly reclusive, Kahn said, "it's not as though anything horrible happened to me."
"I remember feeling something bad was going to happen. I felt dark and low inside."
She said she "cried and cried" when she was diagnosed: "I felt like damaged goods."
Her condition is treated with talk therapy and medication, which was revealed to viewers in the edited versions of conversations taped during the 24-hour-a day, four-month surveillance of Real World's housemates. "It's a pretty bizarre project," Kahn said. Afterward, "I watched my edited self, and I felt totally exposed."
Then the fan letters began to arrive, she said. She did not answer the ones that asked whether her hair is permed or whether she ever hooked up with Kyle. She replied to those who wrote to her about their depression, to tell her they felt better because the famous Cara struggles with it as well.
Their honesty "helped me come to terms that there is no shame in having depression," Kahn said. "With treatment, you can lead an enjoyable life."
Crystal Farina, 19, said she went to the presentation because depression is an issue for college students. "Especially with the heavy drinking and drugs," said her friend Merek Lee.
About 10 percent of America's college students have been diagnosed with depression, the National Mental Health Association says. Suicide has become the third-leading cause of death for young people 15 to 24, behind unintentional injuries (motor vehicle accidents and others) and homicide.
Though the numbers are small _ about a dozen deaths per 100,000 in that age group every year _ more teenagers die from suicide than AIDS, cancer and all other diseases combined, reports the National Institute of Mental Health.
Antidepressants are the No. 1 prescribed medications on college campuses, followed closely by anti-anxiety drugs.
The tour is the latest educational effort by GOAL! Go On And Live, a program sponsored by Wyeth Pharmaceuticals and launched in April with actor Delta Burke, who says she has struggled with depression for almost 30 years. Kahn is paid by Wyeth, which makes the drug Effexor, prescribed for depression and anxiety disorders.
Critics say the campus stops are a corporate promotion. Harvard University declined to host a visit because of Wyeth's commercial interest in promoting medication for mental health.
Drug companies sold $12.2-billion in antidepressants last year.
There was no Wyeth signage at Friday's event on USF's Tampa campus, and Kahn did not specify which drugs she takes. Co-sponsors include the nonprofit National Mental Health Association and Screening for Mental Health Inc.
"Over 80 percent (of sufferers) get significant improvement from counseling alone," said Dale Hicks, a USF psychologist and one of the speakers.
Clinical depression is more than a freshman's homesickness or the stress of cramming for finals. The illness disrupts sleeping, eating, studying and work. Symptoms may include a persistent sadness or anxiousness, feelings of hopelessness or guilt, irritability, low energy, lack of focus and inability to make decisions, difficulty connecting with family and friends and, in severe cases, thoughts of suicide and death.
"It is a medical illness, an imbalance of chemicals in the brain," said speaker Dr. Mark Agresti, a psychiatrist in West Palm Beach whose patients are teenagers and young adults.
Students may put themselves at additional risk for depression by their lifestyle, he cautioned. Alcohol, marijuana and the drug ecstasy contain ingredients that alter body chemicals. "If you use enough, you'll get depressed," Agresti said.
Kahn, a Boston area native and a 2002 graduate of Washington University in St. Louis with a degree in theater, says that treatment "sort of got me back to the way I was."
The time spent on public display, rather than testing her mental stability, proved a healthy distraction, she said. "The post-show was when it got a little iffy," she said.
"I have good days and bad. I still get weepy when I listen to Enya. But I've made a commitment to my mental health."
Dealing with depression
Here are some ways to deal with depression in college:
Don't go it alone. If feelings of stress and sadness go on for weeks or months, seek help at the university counseling service or student health center, or from your doctor.
Plan your day. If you can set priorities, you can achieve a sense of control and the belief you can do it.
Plan work and sleep schedules. Too many students defer class work until late at night or the last minute. Fatigue can trigger depression. Seven or eight hours of sleep per night is important.
Join an extracurricular activity. Sports, theater, clubs or other interests provide a change from school work and a chance to make friends.
Seek support from others. Friendships make a strange place more comfortable, and sharing emotions helps you realize that you alone do not feel this way.
Try relaxation methods. Take a walk or a bath, exercise, meditate or take some other break to relieve stress.
Take time for yourself each day. Even if it's only 15 minutes, focus on yourself to renew energy and re-establish your sense of purpose.
Work toward recovery. Seek treatment. Remission of symptoms is the goal. Adjust treatment if necessary.
Help another. Be honest and ask what is bothering a friend or acquaintance. Listen. If advisable, urge them to get help and offer to go with them to see a counselor or physician.