CONTENTS
2 INTRODUCTION 3 DEPRESSION 5 SEASONAL AFFECTIVE DISORDER 6 ANXIETY 9 PANIC ATTACKS 13 POST-TRAUMATIC STRESS DISORDER 14 OBSESSIVE COMPULSIVE DISORDER 17 EATING DISORDERS 20 BIPOLAR DISORDER` 23 PERSONALITY DISORDERS 24 HELPING YOURSELF 25 HELPING OTHERS 27 SUPPORT
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INTRODUCTION Just like physical health, we all have mental health. Mental
health illnesses are common, can happen to anyone, at any time
and can feel just as bad, or worse, than physical illness – only
you can’t see it. Mental health difficulties are much more com-
mon than you may initially think as 1 in 4 people in the UK ex-
perience some sort of mental health difficulty every year. These
can vary from the worries we may experience day-to-day to more
serious long term conditions.
Unfortunately, there still exists stigma and misunderstanding
surrounding mental health and we generally feel uncomfortable discussing it. By talking about our experiences, which are dif-
ferent for every person, we can educate others and help them
understand, whilst also breaking the silence surrounding mental health and help those suffering seek support. This booklet con-
tains many different anonymised personal stories, information
about support services and tips on how to support loved ones in this booklet we hope to work towards achieving this.
This year we have used stories from past and present students
and we would like to thank them all for contributing to this
booklet: your bravery talking about such difficult issues is really appreciated and you’ve done so much to improve the wellbeing and welfare of the JCR.
If you believe you recognise who may have written it, please keep
it to yourself! Also there are stories within this booklet which
can be difficult to read so trigger warnings have been included throughout.
If you’d like to talk about anything in this booklet the welfare
team are happy to chat and you can also use the anonymous posting system:
community.dur.ac.uk/castle.welfare
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DEPRESSION WHAT IS IT? We all have times when our mood is low, and we’re feeling sad or miserable about life. Usually these feelings pass in due course. But if the feelings are interfering with your life and don’t go away after a couple of weeks, or if they come back over and over again for a few days at a time, it could be a sign that you’re experiencing depression. Depression is a low mood that lasts for a long time, and affects your everyday life. In its mildest form, depression can mean just being in low spirits. It doesn’t stop you leading your normal life but makes everything harder to do and seem less worthwhile. At its most severe, depression can be life-threatening because it can make you feel suicidal or like simply giving up the will to live. SYMPTOMS? Feelings - low-spirited for much of the time; restless and agitated; easily tearful; numb and empty; isolated and unable to relate to other people; unusually irritable or impatient; inability to find pleasure in things you usually enjoy; helplessness; decreased sex drive; a sense of unreality. Behaviour - not doing activities you usually enjoy; avoiding social events you would usually attend; cutting yourself off from others; inability to ask for help; self-harming; finding it difficult to speak or hold conversations Thoughts - difficulty remembering; lack of concentration; inability to make decisions; blaming yourself and feeling guilty; no confidence or self-esteem; negative thoughts; lack of faith in the future; what’s the point?; suicide. Physical - difficulty sleeping; sleeping much more than usual; tired; no energy; lost appetite and weight loss; gained appetite and weight gain; physical aches and pains with no obvious physical cause; slow movement; substance abuse (e.g. alcohol, drugs, tobacco.) Everyone’s symptoms are different. These listed above are the most common, experienced in different ways.
CAUSES? Depression can be due to a number of different factors, examples include: - Life events: triggered by an unwelcome, traumatic event or big life change - Loss: Death of a close loved one, major life change - Anger: may experience something which left you feeling angry and helpless and if you were unable to express your feelings at the time, your anger become internalised and expressed as depression
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- Physical Conditions: Conditions effects the brain and nervous systems, hormonal problems, symptoms relating to menstrual cycle or menopause, low blood sugar, sleep problems, side effects of medication, poor diet, genetics. www.mind.org.uk
ANONYMOUS STATEMENT: (TRIGGER WARNING: DEPRESSION)
Prior to my own struggle, I always found depression a difficult topic to discuss and, if I’m being entirely honest, even to understand. My own difficulties with mental health began in sixth form. I had had a lot of difficulties with anxiety in the run-up to this, but my mental health deteriorated in this period as I struggled with isolation, family and relationship issues and an overall deep sense of helplessness - issues that crystallised in the summer that I left school. Depression can manifest itself in many different ways, and I think this is crucial to remember when trying to support yourself and/or others. For me, my depressive days can range from what feels like a manageable sadness to days when I’m unable to get out of bed and feel completely held hostage by my body and brain and contemplate harming myself. Personally, my episodes can last anywhere between a day and a week. I really struggled in the summer that I left school, as felt abandoned by my friends who seemed unable to support me as soon as I strayed from my normal high energy, enthusiastic self. However, the fact that my depression has vastly improved since my arrival at university is indicative of how many things can be done to cope with, and hopefully overcome, depression. For me, talking and an increased sense of openness has been crucial to my progress, as a means of both support and a reminder that I am not and do not need to be alone. I’ve learnt ways of dealing with triggers, and have found small ways of taking back control on my now rarer bad days - even if my victories are as seemingly trivial as going for a walk when my depression tries to keep me at home. When dealing with mental health, every day is very different, but it’s important not to let mental health define the way you live your life, and so if you are in need of support I could not recommend seeking it more, be it friends or professional.
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SEASONAL AFFECTIVE DISORDER (SAD) WHAT IS IT?
Seasonal affective disorder (SAD) is a form of depression that people experience at a particular time of year or during a particular season. Most of us are affected by the change in seasons – it is normal to feel more cheerful and energetic when the sun is shining and the days are longer, or to find that you eat more or sleep longer in winter. However, if you experience SAD, the change in seasons will have a much greater effect on your mood and energy levels, and lead to symptoms of depression that may have a significant impact on your day-to-day life. www.mind.org.uk
ANONYMOUS STATEMENT: (TRIGGER WARNING: DEPRESSION) There was a time when I struggled every single day with depression, anxiety, and problems surrounding eating and my food habits. My mental health affected my degree, my relationships, and just generally my attitude towards life. I couldn’t count the amount of times I almost dropped out, and the dependency I had on other people for happiness and wellbeing seems shocking to me now. I’d been to my GP before, and they’d put me on one type of medication which I eventually decided to stop taking. I didn’t feel like it was doing anything other than giving me really bad acid-reflux and making me sick most days. Starting on anti-depressants had already been a massive step, and I was so scared to say that they weren’t working. I honestly thought it meant that I wouldn’t ever get better, I didn’t really ever consider the fact that there are so many different kinds of medication, and some things might not work as well for some people as others. Cut to now, I’m on my second type of medication, but on my fifth (I think) dosage change, in order to try and get that balance just right, and there are absolutely no words for how much better I am now. I still get days where I want to hide from the world, or feel a little bit spacey, but I can’t remember the last time I had a dissociative episode or a panic attack. I don’t remember the last time my mental health got in the way of my life, and I am so grateful for all the help that I received, because I really really love my life now, and I wouldn’t do anything to change it.
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My point is there is no-one size fits all fix for bad mental health. It’s really shitty, but if you experience one type of help that doesn’t work, don’t give up. Keep working at it, and try to tell yourself that you’re worth the effort. Talk to your friends, and listen to the amount that they care about your wellbeing. Don’t be scared to ask for help, I absolutely promise you that it’s worth it.
ANXIETY WHAT IS IT? Anxiety is a word we use to describe feelings of unease, worry and fear. Although we usually find it unpleasant, anxiety is related to the ‘fight or flight’ response – our normal biological reaction to feeling threatened. It’s common to feel tense, nervous and perhaps fearful at the thought of a stressful event or decision you’re facing – especially if it could have a big impact on your life. WHEN IS IT A MENTAL HEALTH PROBLEM? Because anxiety is a normal human experience, it's sometimes hard to know when it's becoming a problem for you – but if your feelings of anxiety are very strong, or last for a long time, it can be overwhelming. FOR EXAMPLE - You might find that you’re worrying all the time, perhaps about things that are a regular part of everyday life, or about things that aren’t likely to happen – or even worrying about worrying. - You might regularly experience unpleasant physical and psychological effects of anxiety, and maybe panic attacks. - Depending on the kind of problems you experience; you might be given a diag-
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ANXIETY (CONT.) nosis of a specific anxiety disorder (such as generalised anxiety disorder, panic disorder or post-traumatic stress disorder) SYMPTOMS AND SENSATIONS Physical - - - - - - - - - -
nausea, feeling light headed or dizzy tense muscles and headaches pins and needles faster breathing a fast, thumping or irregular heart beat sweating or hot flushes churning in the pit of your stomach; ‘butterflies’ difficulty sleeping needing to go to the toilet more or less frequently experiencing panic attacks
Psychological - feeling tense, nervous or on edge - having a sense of dread - fearing the worst - feeling like the world is slowing down or speeding up - feeling others can see you’re anxious and are looking at you - feeling that your mind is really busy with thoughts - dwelling on negative experiences, or thinking over a situation again and again (this is called rumination) - feeling restless or unable to concentrate - feeling numb Long term effects - problems sleeping - depression - lowered immune system (which can lead to other physical health issues) - drug misuse as a coping strategy - change in sex drive
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ANONYMOUS STATEMENT: (TRIGGER WARNING: ANXIETY) I’d always been someone who frequently worried about their health, but in the April of my first year, I realised that my worries had become unhealthy. After a 6 hour stay alone in A&E for indigestion chest pains which I had mistaken for a heart attack, I knew that something needed to change and that I needed to stop these unhealthy, vicious thought patterns. It took me a while to accept that I needed help - for me, health anxiety comes in waves, or what I call episodes, so when I’m not experiencing an episode, it’s easy to dismiss the problem overall. But after a while, the episodes started becoming more frequent, and were triggered by smaller things: jaw pain, tiny bumps on my body, bloody noses, non-existent hair loss. I started coming up with symptoms that weren’t even there, and when in the midst of an episode, my life became dominated by a cycle of obsessions and compulsions - obsessively thinking about my health, and compulsively checking my body for new symptoms and fixating upon whatever I could find. When trapped in this cycle, I can’t think about anything else: if I happen to find a bump during a lecture, I immediately stop paying attention because I can’t stop thinking about what the bump could mean. It dominates my thoughts, even when hanging out with friends or working at the library. After yet another episode over the Christmas holidays of my second year, where I basically had a panic attack over a non-existent bump in my neck and saw a specialist who then told me it was literally just ‘a muscle,’ I decided to get help and signed up to get CBT from a free service called Talking Changes. Though it was difficult to finally go talk to my GP, I immediately felt better because I felt like I was taking control of my life. In addition to finally getting help, having supportive friends and family has been extremely helpful - they’ve made an effort to learn about health anxiety in order to know how best to help and support
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me. CBT itself was really amazing – it was hard at first, and I wasn’t sure if it was paying off initially, but my health anxiety has greatly diminished since then, and I hardly ever have episodes anymore, or when I do, they’re relatively minor. CBT equipped me with ways of targeting and changing my unhealthy thought patterns, so I was finally given a solution to escaping the unhealthy cycle. When I do have an episode though, I try to clear my head and think about something else. Reading a book, watching TV, going on walks, doing yoga, or making plans with friends are great ways of distracting myself and blocking out harmful thoughts. If you had told me a year ago that my health anxiety was going to diminish so much over the next twelve months, I would have never believed you, which is why I think it’s so important to remember that there are ways to help yourself, and that it is possible to get better. I’m so grateful for the fact that I’ve been able to heal and grow and take control of my life.
PANIC ATTACKS WHAT IS A PANIC ATTACK? A panic attack is an exaggeration of your body’s normal response to fear, stress or excitement. It is the rapid build-up of overwhelming physical sensations, such as: a pounding heartbeat; feeling faint; sweating; nausea; chest pains; feeling unable to breathe; shaky limbs; jelly legs; feeling disconnected from your body. WHEN DO PANIC ATTACKS HAPPEN? You might have a good understanding about likely situations or places that can trigger an attack for you, or you might feel that your attacks come without warning and happen at random. They usually last between 5 and 20 minutes.
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WHAT TO DO? During a panic attack you might feel very afraid that: you’re losing control; you’re going to faint; you’re having a heart attack; or you’re going to die. It’s important to remember that your body physically can’t maintain this and the symptoms are temporary and will pass. Everyone will find different strategies to overcome panic attacks useful, in general: try to focus on slowing down breathing to a normal rate (there are various different breathing techniques you can use) and try shifting your focus away from the anxiety towards other feelings and senses (such as smells, tastes and sounds).
ANONYMOUS STATMENT: (TRIGGER WARNING – PANIC ATTACKS) My first panic attack came in the summer of 2015 at Leeds festival. I have always been claustrophobic in small spaces - I avoid going in lifts at any cost - but the combination of loud music in a crowded, hot environment sent this claustrophobia to new levels. The experience was truly terrifying; not knowing that I was actually having a panic attack, I convinced myself, instead, that my drink had been spiked. This only increased my sense of anxiety, until it reached the point where my hyperventilation became so intense that I collapsed. Needless to say, this ruined the remaining three days of the festival for me and I think it was this experience which initially triggered my anxiety. In the two years that followed, I had frequent and recurring panic attacks in a variety of situations, ranging from standing in a queue in M&S to working behind a bar on a busy Friday night. What I didn’t know at the time when my panic attacks first started was that I was suffering from an underlying chronic health condition, affecting my heart and autonomic nervous system, which would eventually force me to suspend my A level studies, 3 months before my final exams were due to begin, and retake year 13. This illness increases my susceptibility to heart palpitations, one of the triggers for my panic attacks. This was obviously not convenient for someone with anxiety. Unfortunately, the panic attacks did not become less scary with experience.
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PANIC ATTACKS (CONT.)
However, I learnt ways to calm myself down. I have a sort of “panic attack routine” now: I stand with my hands flat against a wall, close my eyes and take deep slow breaths, in through my nose and out through my mouth. Finding something which worked on several occasions put my mind at ease and I became less anxious about when my next panic attack would come on. Prior to coming to university, I had not had a panic attack since the day of my first A2 exam in June 2017. However, with the stress of leaving home and meeting such large numbers of new people, my anxiety began to rear its head once again. On the most part, my usual routine would work and I’d dismiss any feelings of panic as quickly as they came on. However, there are situations where it is not always possible for me to use my usual technique. For example, being unable to stand up from the table at formals led me to worry about what would happen if I did have a panic attack. This worry, unsurprisingly, caused me to get panicky at formals. Fortunately, the small group of friends who I initially told about my anxiety are good at spotting when I am on the verge and are great at calming me down or distracting me. Although I am not in complete control of my anxiety yet, it has definitely helped me having a strong support system at uni and I would recommend anyone experiencing anxiety, or indeed any other mental health problems, to confide in a friend.
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ANONYMOUS STATEMENT: (TRIGGER WARNING: PANIC ATTACKS) I don't get panic attacks so often anymore, and when I do they're not as bad as they used to be. This is mainly because I have learnt how to deal with them when I feel them coming. When I started having them when I was about 14, I didn't know what they were. I start feeling a tightness in my chest and then my breathing starts catching, and I feel faint. This will then escalate to hyperventilating. This is a really scary experience because I don't feel in control of my body, its as if you're in shock and there's nothing you can do to stop. But now, when I have them, I recognise the feelings and know how to calm myself down. Everyone has different methods, but for me my breathing is the most important. Simple breathing exercises to slow my panic down and breathe calming so that I don't feel faint. I breathe in and out to a certain amount of beats, even sometimes tapping these out with my hand. It really helps me focus on controlling the feeling. Even though it's not something I can control, I still get embarrassed about panic attacks. I don't like the idea of people seeing me go through something like that. But the people who have seen me, have always been very supportive. I would recommend anyone who is trying to support people who have panic attacks read the following tips: 1) don't overcrowd them. If they're panicking, give them physical space, they could be feeling very overwhelmed. You can always reassure them verbally. 2) don't ask a lot of questions. Some people have techniques to calm down, so you could ask them what theirs is and what you can do to help, but try not to ask so many questions that you overwhelm them. Just allow them time to calm down. 3) you can help them by encouraging them to regulate their breathing, or getting them a glass of water, or making sure they are in a safe place, for example helping them get out of a crowded area to a more expansive quiet space.
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POST-TRAUMATIC STRESS DISORDER WHAT IS IT?
If you are involved in or witness a traumatic event, it is common to experience upsetting, distressing or confusing feelings afterwards. The feelings of distress may not emerge straight away - you may just feel emotionally numb at first. After a while you may develop emotional and physical reactions, such as feeling easily upset or not being able to sleep. This is understandable, and many people find that these symptoms disappear in a relatively short period of time. But if your problems last for longer than a month, or are very extreme, you may be given a diagnosis or post-traumatic stress disorder (PTSD). There’s no time limit on distress, and some people may not develop post-traumatic symptoms until many years after the event. Additionally, not everyone who has experienced a traumatic event develops PTSD. SYMPTOMS -Vivid flashbacks (feeling that the trauma is happening all over again); Intrusive thoughts and images; Nightmares; Intense distress at real or symbolic reminders of the trauma. - Physical sensations, such as pain, sweating, nausea or trembling. - Alertness or feeling on edge - Panicking when reminded of the trauma; Being easily upset or angry; Extreme alertness and a lack of or disturbed sleep; Lack of concentration; Easily startled; Self-destructive behaviour - Avoiding memories; keeping busy, or using alcohol/ drugs to avoid memories; Repressing memories (being unable to remember aspects of the event); Being unable to express affection, feeling detached, cut off and emotionally numb
OTHER TERMS FOR PTSD The diagnosis ‘PTSD’ was first used by veterans of the Vietnam War, but the problem has existed for a lot longer and has had a variety of names, including: - shell shock - soldier’s heart - battle fatigue - combat stress - post-traumatic stress syndrome (PTSS) However, it is important to remember that today the term PTSD can be used to describe the psychological problems resulting from any traumatic event, not just war. www.mind.org.uk
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OBSESSIVE COMPULSIVE DISORDER WHAT IS IT? Obsessive Compulsive Disorder – more commonly known as OCD – can generally be defined as a condition where a person is governed by obsessive thoughts and compulsive activity. The crucial thing to be aware of with OCD is that it is a condition very particular to the person who is suffering from it.
OBSESSIONS These are unwelcome thoughts, images, urges or doubts that repeatedly appear in your mind; for example, thinking that you have been contaminated by dirt and germs, or experiencing a sudden urge to hurt someone. These obsessions are often frightening or seem so horrible that you can’t share them with others. The obsessions interrupt your others thoughts and makes you feel very anxious.
COMPULSIONS These are repetitive activities that you feel you have to do. This could be something like repeatedly checking a door to make sure it is locked or repeating a specific phrase in your head to prevent harm coming to a loved one. The aim of a compulsion is to try and deal with the distress caused by the obsessive thoughts and relieve the anxiety you are feeling. However, the process of repeating these compulsions is often distressing and any relief you feel is often short-lived. www.mind.org.uk
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OCD (CONT.) ANONYMOUS STATEMENT: My parents have told me that my OCD was apparent even from a young age, where I would obsessively check the towels in the bathroom before I could go to bed. However, it became particularly bad when I was at secondary school: when work got stressful and I had GCSE’s it really escalated and it got to a point where I was taking hours to go to sleep because of weird obsessive routines that I felt I had to cover. It is a bizarre thing because you know how utterly irrational it is that if you don’t say goodnight to a photo of your family then they will die, but you still do it twenty times because you can’t sleep until it is done. I was also absolutely afraid of dirt and washed my hands countless times a day (I know I am stressed when my hands get very dry because of all the washing), and this would escalate when I was stressed just like these nighttime routines. It got to a point where large parts of my day were impeded and my parents/those that looked after me at boarding school knew I needed help. Luckily, I saw a really excellent therapist. He would set me tasks like not doing a tiny bit of the pre-bed routine or touching the bathroom floor and not washing my hands (sounds silly but that seemed impossible) and slowly it helped. I am so much more in control of it now and I can self regulate really well, but I still have to keep on top of it. I can recognise when I am getting really obsessive and I often just allow myself an hour or two to clean and tidy my room and then leave the space to calm down. Often talking about it away from the space or environment that is inducing the obsessive behaviour really helps. I also think that I have learnt to deal with work stress better and that means academia doesn’t worsen my OCD (that is something I would advise working on). OCD never goes away though, and I still have small nighttime routines (and my hands are very clean), but it doesn’t encroach on my life at all at the moment so that is just where it needs to be maintained.
ANONYMOUS STATMENT: I think there are a lot of misconceptions about Obsessive-Compulsive Disorder (OCD) and that people often throw the term around without really understanding what it means. I know the term is used a lot to describe people that are overly neat or fussy about certain things, e.g. “I have to have my desk ordered in a certain arrangement”,
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“I have to eat my food in a certain order” and people will respond “oh, that’s so OCD”. I used to think this too, until my second youngest brother developed OCD as a real medical condition. I would joke about my other brother, my youngest, being OCD because he was a very organised person and would like his bookshelf in a particular order. In reality, OCD is an illness where the sufferer experiences uncomfortable or unsettling thoughts and feelings and this lead to compulsions which are repetitive patterns of behaviour that calm down and relax the sufferer. In my brother’s case, he would experience a regular feeling of being incredibly unclean/covered in germs particularly on his hands, legs and feet. This would compel him to regularly wash himself, both his whole body under the shower, and his hands with copious amounts of soap, or to wash his clothes/bedsheets/towels/sofa-covers etc. several times a day because he would think they were covered in germs/urine/dirt or sweat. It would get particularly bad at night where he would go to the toilet, wash his hands, shower, and go back to bed, lie down for a second and then go straight back to the toilet, sometimes for several hours on end. I first noticed it during the summer of year 10 when he was in year 9. He just got braces and had been strongly instructed by the dentist to regularly brush his teeth and keep a very clean mouth. At the time he was also dealing with a lot of peer pressure from friends that would force him to get into trouble at school or to go to parties that he didn’t want to go to. This is when I noticed the link between his stress and the worsening symptoms of continual bodily washing and washing of clothes. It would also get particularly bad during exams times. It was very hard to live with for the two to three years where he had to be on medication to keep it in check and it put the family under a lot of tension. If you tried to reason with him or rationally explain to him that he wasn’t dirty and didn’t need to wash himself it would make it worse and make him very angry. As stupid as it sounds, it would be better to let him finish his ‘washing cycle’ and then try and talk sense to him. He refused any medical help for quite some time, wanting to believe that his behaviour was normal and that he wasn’t ‘weird’ or that there was nothing wrong with him. It was quite upsetting because I felt like it was not my brother in the moments where he was doing his compulsive behaviour ‘rituals’ but that somebody else, an imposter, had taken his place. It was hard for me too because he didn’t want anyone at school to know and I would have friends asking why they’d seen my brother going into and out of the school toilets several times in the space of a few minutes. Luckily it got better with age and as he came out of puberty and matured and he did eventually agree to talk to psychiatrists. Now he is absolutely fine and exhibits no symptoms and has had no problems living away from home. He is now at Uni with a shared bathroom and shower and it was a real worry for us that he wouldn’t be able to function in this kind of environment. He also no longer needs any pills. OCD doesn’t go away but thanks to his therapy he has learned to recognise it, accept it and live with it and control it. This shows that no matter how dark things may seem in the moment there is always light at the end of the tunnel, and that with the proper care and treatment, people can get better and be able to function as happy and healthy human beings.
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OCD (CONT.) Often people with OCD are treated with Cogitative Behavioural Treatment (CBT). CBT is used to help treat a range of other mental health problems too, such as depression, anxiety, eating problems, psychosis, and PTSD.
WHAT IS CBT? CBT is a type of talking treatment that focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviour, and teaches you coping skills for dealing with different problems. It combines cognitive therapy (examining the things you think) and behaviour therapy (examining the things you do). HOW DOES CBT WORK? In CBT you work with a therapist to identify and challenge any negative thinking patterns and behaviour which may be causing you difficulties. In turn this can change the way you feel about situations, and enable you to change your behaviour in future. You and your therapist might focus on what is going on in your life right now, but you might also look at your past, and think about how your past experiences impact the way you see the world.
EATING DISORDERS Food plays an important part in our lives, it is something that most of us enjoy and don’t need to think about too much. But for others it brings endless challenges and stress to everyday life. Eating problems and disorders are incredibly common, although it may not always seem like this. Having an eating problem can be very hard to cope with but it’s important to understand that eating problems aren’t just about food. They can be about difficult things in your life and painful feelings, which you may be finding hard to express, face or resolve. There exist a whole range of eating problems and disorders, none more or less important:
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Bulimia nervosa: One of the most common, categorised as binging followed by purging. This can be difficult to spot as often weight remains roughly the same. Anorexia nervosa: Restricting food intake to the point you aren’t consuming enough nutrients or energy to be physically healthy. Often connected to low self-esteem, negative body image and feelings of intense distress. Binge eating disorder: Inability to stop eating, even if you want to. Food may be masking feelings or providing emotional support. EDNOS (eating disorder not otherwise specified): Some but not all of the criteria of other eating disorders. EDNOS are a very serious illness, and are often more confusing to deal with. visit www.mind.org.uk for more detailed descriptions
ANONYMOUS STATEMENT: (TRIGGER WARNING: EATING DISORDERS & SELF-HARM) It’s always difficult trying to explain something to someone who doesn’t understand it, or have immediate access to someone who does: whether that be the rules of lacrosse, a logic problem or an eating disorder. But of course, the latter is certainly the most challenging, especially considering that every person’s experiences and ways of coping are completely different. Although I can pin point roughly when my bulimia started, following the summer of AS and being on a school trip on a beautiful beach in Mexico with my peers, it is difficult to explain what exactly it was that triggered my brain to perceive food as such an enemy. Since around year 9 I’ve always been health conscious, going months being a vegan, vegetarian or no added sugar and then punishing myself when I fell short - thus eating what I wanted and purging it away seemed a convincing solution to my battle with food. Initially, it seemed the most comforting solution - I could eat normally and indulge in the foods I enjoyed but never gain weight if I threw up most meals. However, just as washing my face morning and night was a routine, so became purging and as I became more used to this repetition, I slowly became obsessed - every time I ate something all I could think about was how easy my meal would be to purge or, if I ate just one more biscuit, how much more I may have to exercise at the gym in case I didn’t manage to throw it back up. Because of this and because I was eating normally, with the occasional binge, I couldn’t see that there was a problem - as long as I kept eating and purging I could maintain control and balance, plus, if I’m not skinny I can’t
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EATING DISORDERS (CONT.) possibly have a problem? But then it kept spiralling, becoming more about control and being on top of everything than simply just the food I was consuming, as well as a form of self-harm. In my mind, I had three options; either I didn’t eat anything, I ate and purged, or I ate, didn’t purge and then would have to take it out on myself in other forms of self-harm. Having such a solid support through my friends and boyfriend was comforting, but I still felt as if I was being a burden to them, especially when many of them had faced issues surrounding EDs and other mental health issues before through themselves, family and friends, undoubtedly made worse both by social media’s glorification of an idyllic, skinny girl alongside the taboo of discussing mental health, whether that be in college, with friends or with doctors. Finally, after being pushed by those who truly cared, I decided that I needed to seek medical help, yet I was absolutely terrified that they’d send me away, seeing as I was still quite sure I did not have anything to worry about. I was fine! After being weighed, height checked and having my blood pressure taken I was told ‘well your BMI is fine, you’re in the lower end in the green, so maybe if you just try not to be sick?’. But I don’t want to be green, I want to be in the red. The continuous disappointments from the doctors not only motivated me to decrease my BMI, but further made me want to keep my eating problem hidden away, scared people may say that because I was turned away by GPs, I was just making it up ‘for attention’. Being told that maybe I should just try to stop by doctors happened several more times but, finally, I managed to get blood tests and a hope at a referral to a specialist clinic - but with my blood levels still only being ‘slightly’ too high or low, I was still seen as not in desperate need of a referral. Following such disappointments, I was utterly terrified about the transition to university, not only being in catered halls (removing my control over what I was cooking for myself and increasing my chance of bingeing) but fearing isolation, having lost immediate support from home. However, things are looking up: I have the most fantastic girls here who are so supportive and, although I am by no means beyond bulimia, I am really trying to focus on getting fit and using food to build muscle as oppose to seeing it as an enemy. Hopefully, I will learn to love my body sooner than I know.
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WHO CAN BE EFFECTED BY EATING DISORDERS? In short: ANYONE. There is no single cause of eating problems, and sometimes it can be hard to understand why it has become an issue for you. The reasons for your eating problem may be very complex and confusing. While you may feel that a problem you have with eating is unusual or shameful, you are not alone. Eating disorder charity beat has estimated that about 1.6 million people in the UK are affected. Eating problems can affect anyone, regardless of background or gender. USEFUL CONTACTS for people with eating problems and disorders: www.b-eat.co.uk - Beat. The leading UK charity support for those with eating disorders. www.mind.org.uk - not specifically for eating problems and disorders, but informative and has an extensive list of support advice. www.mengetedstoo.co.uk - MGEDT. Aimed at male sufferers, tackling both the issue of eating disorders, and also the stigma against male sufferers. www.anorexiabulimiacare.org.uk -ABC. A UK based charity with over 25 years’ experience. Also has a helpline for families.
BIPOLAR DISORDER WHAT IS IT? Bipolar disorder is a mental health problem that mainly affects your mood. If you have bipolar disorder, you are likely to have times where you experience: -Manic or hypomanic episodes (feeling high) -Depressive episodes (feeling low) -Potentially some psychotic symptoms during manic or depressive episodes Everyone has variations in their mood, but in bipolar disorder these changes can be very distressing and have a big impact on your life. You may feel that your high and low moods are extreme, and that swings in your mood are overwhelming
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BIPOLAR DISORDER (CONT.) MANIC EPISODES They can feel fun and exciting, however they can also be distressing, disorientating or unpleasant. HOW YOU MIGHT FEEL - happy, euphoric or uncontrollably excited – like you can’t get your words out fast enough - irritable and agitated - have increased sexual energy - easily distracted, like your thoughts are racing; difficulty concentrating - very confident or adventurous; like you are untouchable or can’t be harmed; like you can perform physical and mental tasks better than normal HOW YOU MIGHT BEHAVE - more active than usual - talking a lot, or very quickly, or not making much sense - being very friendly - saying/ doing things that are inappropriate or out of character; losing social inhibitions; taking serious risks with your safety - sleeping very little, or not at all - being rude or aggressive - misusing drugs or alcohol - spending money excessively and inappropriately DEPRESSIVE EPISODES Symptoms and feelings are very similar to those previously discussed in the depression subsection
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MIXED EPISODES Mixed episodes are when you experience symptoms of depression and mania or hypomania at the same time. This can be particularly difficult to cope with, as: - - - -
it can be harder to work out what you’re feeling and what you want it might feel even more challenging and exhausting to manage your emotions you may be more likely to act on suicidal thoughts and feelings others may struggle to know how to support you best
PSYCHOTIC EPISODES Not everyone with a diagnosis of bipolar disorder experiences psychosis, but some people do. Symptoms include delusions (such as paranoia) and hallucinations (such as hearing voices). TYPES OF BIPOLAR Bipolar I: if you have had at least one manic or high episode that has lasted at least a week; you may only have manic episodes however most have depressive episodes too; untreated, a manic episode will generally last 3-6 months; depressive episodes can last 6-12 months without treatment Bipolar II: if you have had more than one episodes of severe depression, but mild manic episodes – called ‘hypomania’
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PERSONALITY DISORDERS WHAT ARE THEY? The word ‘personality’ refers to the pattern of thoughts, feelings and behaviour that makes each of us the individuals that we are. These affect the way we think, feel and behave towards ourselves and others. Personality disorders are a type of mental health problem where your attitudes, beliefs and behaviours cause you longstanding problems in your life. Your experience of personality disorder is unique to you. However, you may often experience difficulties in how you think about yourself and others. You may find it difficult to change these unwanted patterns. WHAT ARE THE SIGNS OF A PERSONALITY DISORDER? You might be given a diagnosis of personality disorder if all three of these apply: - The way you think, feel and behave causes you or others significant problems in daily life. For example, you may feel unable to trust others or you may often feel abandoned, causing you or others unhappiness. - The way you think, feel and behave causes significant problems across different aspects of your life. You may struggle to start or keep friendships, to control your feelings and behaviour or get on with people at work, for example. - These problems continue for a long time. These difficult patterns may have started when you were a child or teenager and can carry on into your life as an adult.
Psychiatrists tend to use a system of diagnosis which identifies 10 types of personality disorder, grouped into three categories: Suspicious PDs: Paranoid; Schizoid; Schizotypal; Antisocial Emotional and impulsive PDs: Borderline; Histrionic; Narcissistic Anxious PDs: Avoidant; Dependent; Obsessive Compulsive visit www.mind.org.uk for more detailed descriptions
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HELPING YOURSELF Looking after your mental wellbeing is just as important as your physical wellbeing (and they are definitely linked!). There are many activities you can do in Durham to look after your mental wellbeing, that are also fun and relaxing, that you have not have considered such as: 1. EXERCISE As well as helping your physical wellbeing, exercise helps boost mood, concentration, relieves stress and improves memory and sleep. There are loads of opportunities to exercise in Durham: you could try out a new sport (either at Caste or uni wide); pop down to Aerobics on Saturday morning in the Undie; grab a friend and head to Moatside gym or even try a fitness video from the comfort of your own room. 2. TAKE BREAKS AND SOCIALISE With deadlines and exams looming, it’s vital to remember to take a break! There’s more to Durham than just libraries - regular breaks with help you feel less stressed and will help you focus. Also, don’t forget about your social life. Feeling lonely at uni is not uncommon and, whilst sometimes difficult to make yourself do, engaging in social activities can help this, especially as you’re unlikely to be the only one feeling this way. Social activities can also be really important in ensuring that you have some downtime away from academic or other pressures, so it’s definitely worth giving a go whether that’s planning a day trip, going for a coffee or having a relaxed movie night with friends. 3. DO SOMETHING YOU’RE GOOD AT Having a good self-esteem really helps with your mental wellbeing. Find a hobby you enjoy and feel good while doing. There are loads of societies both in Castle and uni-wide that you can join at any point of the year (such as CCA which is also a great way to give back to the community!) 4. TALK ABOUT YOUR FEELINGS Talking things through can really help and give you a new perspective, so if a friend comes to you make sure you listen! As well as friends, you can also chat to the welfare team, college office or the counselling service about absolutely anything that is on your mind. It is also possible to find sources of support through social media and websites, for instance Mind have an online community called ‘Elefriends’ where you could find people experiencing similar thoughts and feelings. 5. THINK BEFORE YOU DRINK There’s a reason we feel so rough the day after drinking: alcohol is a depressant. Alcohol can make our mood and wellbeing much worse in the long run so try to drink in moderation. 6. EAT WELL Nutrients and vitamins are important for your body and brain, and hence your mental health. Try and maintain a healthy, balanced diet with as much fresh fruit and vegetables as possible.
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7. MINDFULNESS AND MEDIATION There are loads of different ways you can try this, such as adult colouring books or mindfulness apps. Just make sure you keep it up, even just 10 minutes a day, in order to see the full benefits. 8. ECOTHERAPY This basically means get out and about and enjoying nature! There are so many beautiful countryside walks surrounding Durham that are definitely worth doing. Going outside can instantly change your mood and natural surroundings can be hugely calming.
HELPING OTHERS You might not be experiencing a mental health difficulty, however someone you care about could be. Being a supportive friend/ relative can make such a huge difference BE THERE They might want to talk about it, they might not. Let them decide, and don’t pressure them either way. You simply being there, showing them you are willing to provide support, can mean the world. REMEMBER THEY ARE MORE THAN JUST THEIR DIAGNOSIS People don’t want to be defined by their diagnosis so remember everything else that makes them who they are and don’t treat them any differently.
BE OPEN MINDED As everyone’s experiences are so different it can sometimes be hard to completely understand so just do your best to listen, be non-judgmental and receptive. Try and avoid phrases like ‘pull yourself together’, ‘cheer up’ or anything else that may sound like you’re dismissing their feelings. Whilst that’s not the intention, some off the cuff comments can be quite unhelpful and even hurtful so bear this in mind.
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ASK HOW YOU CAN HELP Often people require different forms of support at different times, it’s totally okay to ask how you can best help! LOOK AFTER YOURSELF It can be easier to support someone if you’re not the only one doing so. Take time to talk to someone about how you’re feeling, as if you begin to be affected yourself you’ll be less able to help. One way you can do this, without feeling like you’re breaking any sort of confidentially, is through using the anonymous posting system (community.dur.ac.uk/castle.welfare).
ANONYMOUS STATEMENT: Reflecting back on the past four years of my life, it has been a journey of ups and downs all allowing me to develop my mental strength and well-being whilst learning how to support those with mental illnesses. In 2014, I was confided in by one of my closest friends about a mental illness they had been struggling through over the past few months. Unsure of how to initially react on such a sensitive topic, especially one so difficult to comprehend, I was uncertain as to how to provide support for them. Over the next few years I learnt that the greatest support I could give them was to listen, just sit with them and listen. Encourage them to talk to you, to tell you how they feel, to seek help and advice if they needed it, remaining positive, but this can take its toll on you; and that is completely okay. However, instead of focussing on them, I want to focus on you: the one supporting the friend, the sibling, or the family member with the mental illness. Looking after and supporting someone with a mental illness can be difficult at times, you can often feel a sense of guilt, or helplessness as you attempt to understand what they’re going through or how to ‘fix’ it. However, I need you know these three things:
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1. It is not your fault, and you are not to blame. 2. It is not selfish, to sometimes feel overwhelmed with it all. It is completely okay to not be okay. 3. Things will eventually be okay. It can be easy to get caught up in it all, which can lead to you neglecting how you’re really feeling, when in reality it is important that you make sure you yourself are okay mentally and emotionally. I would do anything for my best friend, as I am sure many others would; I’d happily drop everything to be there for her, forget my own issues to make sure she was okay, even if at times it meant sacrificing my own happiness. However, I learnt the hard way that that this was not healthy or sustainable when other friends and family noticed how constantly drained I was. It is tough to put on a brave face for other people, when you yourself aren’t happy or okay. I felt guilty sharing my issues, worries or how I felt in order to avoid burdening anyone, little did I know how much it would all pile on me and how down I would consequently feel. Therefore, I am writing this in the attempt to help you realise if you are going through something similar at the moment, that it is really important to, every so often, take a step back to reflect on how you feel, and occasionally prioritise your own happiness. You have to stay positive, not only for those around you, but to ensure you don’t fall into a spiral of stress and unhappiness yourself. Take a day off, have a cup of tea, listen to your favourite song, go for that walk, buy yourself that chocolate bar, look after yourself. Whilst helping and supporting others, please don’t forget about yourself. You’re well-being and mental health is important, your issues aren’t small or irrelevant. You matter. Look after yourself. Everything will eventually be okay.
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SUPPORT If you feel you’re at risk of harming yourself or others, or would consider yourself to be in crisis, immediately contact one of the below: NHS During office hours contact your local GP surgery (University Health Centre, 0191 386 5081), or the non-emergency line after hours (111)
Local Hospital Go to your local A&E or call 999 for an ambulance or police in an emergency.
Samaritans They offer confidential support to anyone in a crisis, 24 hours a day, every day. 116 123 / jo@samaritans.org Drop-in service (9.30am-9pm) 26 Sutton Street, DH1 4BW
CALM: Campaign Against Living Miserably Helpline specifically for men between 15-35 who are in a depressive crisis situation or suicidal 0800 58 58 58 (5pm - midnight, every day) www.thecalmzone.net
PAPYRUS - Prevention of Young Suicide For suicide prevention, for people under 35 HOPELineUK - 0800 068 4141 Monday – Friday 10am - 5pm & 7pm-10pm Weekends 2pm-5pm
College Porters You can call the Porters for advice 24/7: 0191 334 3800
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SUPPORT (CONT.)
OTHER (NON-EMERGENCY) SUPPORT SERVICES College Office Richard (Dickie) Lawrie (Acting Master): Student support are always available for meetings if you email to book (univcoll.studentsupport@durham.ac.uk) or pop down to college office and ask in person. Ric Whaite (College Chaplain)
The Welfare team – A student run confidential listening service that can signpost you in the right direction for further help – Provides sexual health supplies as well as earplugs, sleeping masks and emergency tampons and sanitary pads – Drop-in sessions every day – One-to-one evening drop-ins – Email or message any of the team for a 1-on-1 drop in or query – Anonymous Posting System: community.dur.ac.uk/castle.welfare
Nightline – A confidential listening service, run by students – 9pm - 7am every night of term – Phone: can be found on the back of your campus card and on duo – Instant message: community.dur.ac.uk/nightline
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Durham University Counselling – The Counselling Service offers a high standard of service in counselling for those who are finding that their difficulties are hard to manage and/or are affecting their studies. – Make an appointment by: Email counsel.service@durham.ac.uk; or phone 0191 334 2200
Heads Up – Durham’s branch of student minds— a nationwide charity aiming to raise awareness and support for mental health problems in universities. – Host regular meetings and events, open to all – heads.up@durham.ac.uk / www.studentminds.org.uk / ‘Heads Up Durham’ on Facebook
EXTERNAL USEFUL WEBSITES www.mind.org.uk www.time-to-change.org.uk www.rethink.org www.mentalhealth.org.uk www.sane.org.uk www.ocduk.org www.bipolaruk.org.uk www.depressionalliance.org
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THANK YOU AGAIN TO THOSE WHOSE STATEMENTS HAVE HELPED TO INFORM THIS BOOKLET AND MAKE IT POSSIBLE. BRAVERY AND COURAGE TO TALK SO OPENLY ABOUT MENTAL HEALTH HELPS TO BREAK THE TABOO SURROUNDING DISCUSSING MENTAL HEALTH AND GREATLY IMPROVES THE WELFARE AND WELLBEING OF MEMBERS OF OUR JCR, IF ANYONE WOULD LIKE TO CHAT ABOUT ANYTHING DISCUSSED IN THIS BOOKLET, PLEASE DON’T HESITATE TO CONTACT THE WELFARE TEAM.