TORONTO - Erin Boyd thought she had the world by the tail when she was admitted to medical school.
"I was over the moon, I was so excited," she says.
But the University of Toronto student sank into a debilitating depression and attempted suicide this year.
"People assume good marks and having friends means you can't have depression," says Boyd, 27. She was so afraid of letting people down that she didn't tell anyone how dire things were - or seek the supports available on campus - until she had made an attempt on her life.
Boyd's story is a cautionary tale for the upcoming school year as hundreds of thousands of students descend upon Ontario's campuses - many leaving home for the first time and handling finances and social pressures on their own.
Canadian universities take mental health issues seriously and offer counselling to thousands who find their struggles on campus are affecting their academic performance.
Dr. Leslie Nickell, associate dean for health professional students at U of T, says the competition to get into school and then achieve - which is amplified in the professional schools - is very stressful.
"All students experience stress. About 30 per cent will feel anxiety and depression," Nickell says. "As well, I think the type of student that typically applies to medical school has a very high set of expectations for themselves."
It's not surprising Boyd hid her suffering, Nickell says. "Society still has the stigma, less so than before but it is still there. "
"There are high stakes involved here. And people have capacity for denial and to push themselves."
Mental health resources have steadily improved over the past 20 years, says Phil Wood, vice-president of student services at McMaster University in Hamilton, as universities become more accessible to students with diverse backgrounds, including those with disabilities and from under-represented populations.
The school has widened its campus mental health network by distributing resource material to raise staff awareness.
Students attending orientation festivities at McMaster next week will see an outdoor play titled "Iris" about mental illness on campus that presents a student who skips class and can't get out of bed.
More than half of the students coming to McMaster mental health centre for counselling report depression or anxiety while 15 per cent are having trouble adjusting, such as feeling homesick.
One in 10 university students has suicidal thoughts, Wood says. "It is not abnormal or out of the ordinary."
Boyd says her constant thought was that she was "wasting the opportunity" of medical school for which others would have been so grateful.
"I have a lot of great friends and a great family but I still felt incredibly isolated. I had thoughts of suicide. I knew how much it would hurt them so I used to wish a car would swerve over and hit me."
Since suicide crosses so many young people's minds, it is difficult to know when to intervene, says Marc Wilchesky, executive director of counselling and disability services at York University, where the vast majority of students are commuters.
"You don't want to get someone in hospital who doesn't belong there," he says. "But you don't want someone to kill themselves, either."
In his 24 years at the university, he isn't aware of any student who received treatment but went on to take his or her own life. "The threshold has changed how quickly we respond."
York has a special team that swoops in to help students who experience a traumatic incident. It was used recently when a professor suffered a heart attack and died while giving a lecture to 150 students, Wilchesky says.
Dr. Su-Ting Teo, director of student health at Ryerson University, says society's awareness of mental health has changed.
"It gets named, it gets talked about and it gets training and support that you wouldn't have had 10 or 20 years ago."
On top of the 12 professional counsellors available at the medical centre, Ryerson also hires students as outreach workers on it campus in downtown Toronto.
This year, they've been set the task of coming up with an anti-stigma campaign.
"The stigma is such a barrier," Teo says. "If you can't get past the stigma, you can't help."
At Queen's University, where 90 per cent of the roughly 18,000 students are living away from home, there is the challenge of providing support for students far from family supports, says Mike Condra, director of health counselling and disability issues.
The university trained 300 front-line staff who work with students to spot signs of trouble and offer help in a program titled Mental Health First Aid.
"The focus is on early intervention," he says.
Boyd says her message to other students is that they shouldn't struggle alone. They should seek help when they feel "something isn't right."