The Castle Guide to Mental Health

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The Castle Guide to

Mental Health



Contents 2 4 7 10 12 14 16 20 22

Introduction Depression Eating Problems and Disorders Anxiety Obsessive Compulsive Disorder Bipolar Disorder Helping Yourself Helping Family and Friends Mental Health Support Services

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INTRODUCTION This booklet will explore various types of mental health issues, discuss how to keep ourselves healthy, as well as give information on how to help family or friends who may be suffering. We have also collected stories of personal experiences - thank you so much to those of you who have contributed. We all have mental health, just like we all have physical health. Both change throughout our lives and like our bodies, our minds can become unwell. Mental health problems range from worries we may experience day-to-day, to more serious long-term conditions. Like other illnesses, mental illnesses are common and can occur to any of us at any time, but you are never alone, as one in four of us will be affected by mental health each year. It can impact on our behaviour and how we think and feel about ourselves. However, everyone is different and will be affected in different ways. Our mental health doesn’t always stay the same either and is likely to change with circumstances. There is a stigma attached to mental health problems and we often feel uncomfortable talking about them or about our feelings generally. We hope that this booklet will provide useful information and guidance, but will also help us to discuss these issues more openly and break the silence surrounding mental health.

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“Mental illness is a chemical imbalance of the brain; just as with any other illness, it is a deviation from the norm. The fact that it is invisible or can be treated by mind over matter doesn't make it any less of an illness. In fact that only makes it more tricky. The person cannot simply be cured by a professional, they must learn how to cure themselves. If knee surgery could only be performed by the patient, and they must be trained in the procedure before doing it themselves, would it be considered any less of an operation? Therapy is teaching a person how to fix themselves. Just as physical therapy provides the patient with exercises to strengthen weakened muscles, so is a mental patient taught how to change their brain, change the mental pathways taken and so the chemical balance of the brain. This deviation in chemical balance can occur for a myriad of reasons: genetic disposition, loss, unhappy situation. Just because one person suffers and the other doesn't does not make them weaker; no two peoples circumstances are exactly the same. It just takes a knock off kilter, left unchecked, to lead the mind into an entirely different state. If a compass is out by just 5 degrees, miles down the line you will be a long way from your original destination. This is what happens to a person suffering from a mental illness, they somehow got set on the wrong path and subtly, their perception of reality changes. The change is so subtle, like the daily ageing of a persons face, that it's not noticeable until suddenly (sometimes years down the line) something happens which makes them realise their perception of reality is wrong. It is at this point that they go and seek help. Even though slipping into the wrong state of mind was easy, correcting it is not. Because your natural instincts tell you are right. Having a mental illness is like seeing a blue square when everyone else sees it as red. No matter how much you tell yourself the blue square is actually red, it remains blue for an awfully long time. It may have taken years for your mind to see blue instead of red, sometimes it'll take even longer to change the colour back. The hardest thing I have ever done was to acknowledge that the world as I saw it wasn't true. It is a terrifying thought. Next time you wonder why someone with a mental illness is acting irrationally, or why they can't 'just snap out of it', remember that though it's ridiculous to you, it's reality to them.�

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DEPRESSION What is it? Depression is a serious but common mental disorder causing someone to experience intense emotions of anxiety, negativity and helplessness that’s recurrent and regularly interferes with life. In the U.K depression affects one in five people and varies in severity. In its mildest form, depression can simply mean being in low spirits, making everyday tasks harder and less worthwhile. In its most severe form, clinical depression can cause suicidal feelings and be life-threatening. Depression presents itself in a many different ways, you may not realise what’s going on because sometimes your problems seem to be physical rather than mental or emotional. The length of time and severity of depression is highly varied between suffers and can affect anyone. Depression is also commonly linked to other mental health problems such as anxiety and psychotic experiences. Signs and Symptoms • Tiredness and loss of energy. • Sadness that doesn’t go away. • Loss of self-confidence and self-esteem. • Difficulty concentrating. • Not being able to enjoy things that are usually pleasurable or interesting. • Feeling anxious all the time. • Avoiding other people, sometimes even your close friends. • Feelings of helplessness and hopelessness. • Sleeping problems - difficulties in getting off to sleep or waking up much earlier than usual. • Very strong feelings of guilt or worthlessness. • Finding it hard to function at work/college/school.

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• Loss of appetite. • Loss of sex drive and/or sexual problems. • Physical aches and pains. • Thinking about suicide and death. • Self-harm. 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 • 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. Self-help and support Taking control of depression: Often depression can be consuming, the important thing is to accept there is usually no instant solutions to problems in life. Finding solutions is going to take time, energy and work and when you’re feeling depressed you may not be motivated to work. But if you are able to take an active part in treatment it should help the process. • Breaking the cycle of negative thoughts: trying to recognised the pattern of negative thinking when you are doing it and replace it with a constructive activity. • Keeping Active: Regular exercise can be effective in lifting mood, confidence, appetite, sleep and energy levels – just 20 minutes of your activity of choice can make a difference! • Contact with people: Keeping in touch with people and friends can help you feel more grounded and sometimes help get things into perspective (e.g. phone call to friend or relative) as well as generally make you feel more involved.

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• Treat/care for yourself: - Treats that make you feel good: long bath, day out with friends - Attention to your personal appearance - Setting goals that can be achieved to increase sense of satisfaction - Looking after yourself: by eating healthy - Being causes of tobacco, alcohol or other drugs which can make depression worse.

“My name is Kirsten, and I suffer from depression. There is such a taboo around discussing mental health issues and I’ve always wanted to change that. Being able to talk about it with my friends and family has helped me in such a huge way, and I’m improving so much that I no longer have to take medication to be able to get by everyday. Without being open about my illness I think it would have taken so much longer to be able to manage it, and I really want to encourage people to learn more about it and feel comfortable discussing these issues. Depression is difficult to describe. To me it feels like a constant dark cloud in the back of my mind. Some days it’s right at the back, barely noticeable, others it encroaches into all my thoughts. I lose motivation. I lack the ability to care about anything or anyone. At one point in my life these days were constant, for months without a break. It’s exhausting. I was lucky though. I had people around me who understood the illness and helped me through it. Let me be when I hated everything, and stood by me when I wanted to talk. Now I haven’t had a ‘bad’ day for a while and I’m living my life pretty much like I used to before. So it does get better, and for those of you currently suffering I’d encourage you to talk, to get help, because no matter how strong you are it isn’t something you have to do by yourself!”

Kirsten Ash

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EATing problems and disorders Coming to university is a huge life change that can be stressful as well as exciting and fun. Food plays a huge part in our day-to-day 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. University life brings a new level of independence that many have not experienced before. With this comes the responsibility of what we eat and drink to keep us healthy. For some it is an easy transaction, but for others it is a much more complicated process. Everyone jokes about the classic Freshers’ Fifteen, as we eat the endless potatoes at college dinner and maybe drink a little bit more than we used to, but for some this poses a real problem. There is a whole range of eating problems, none more or less important than others. Bulimia: • Binge eating followed by purging • Can be difficult to spot as weight generally stays roughly the same Anorexia Nervosa: • Not allowing yourself to eat enough to keep you healthy • Often associated with very low self-esteem, negative self-image, intense feelings of distress and perfectionism Binge Eating Disorder: • Being unable to stop yourself from eating, even if you want to • Feeling a reliance on food for emotional support, and using food to hide difficult feelings Eating Disorder Not Otherwise Specified (EDNOS): • Having some but not all of the criteria of other eating disorders • EDNOS can seem like it is a less serious illness than other eating disorders, but this is not the case

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There is no one single cause of Eating Disorders; they can be brought about by a huge number of reasons: • Difficult experiences e.g. bereavement, abuse of any kind, bullying, exam stress and pressures, leaving home for the first time, working out your sexuality • Feeling out of control – food can be used as a means of having control over at least one area of life, this is especially appealing if everything else seems out of your control • Personality traits – eating disorders are often linked with perfectionism, being highly competitive or self-critical and having trouble expressing yourself • Other mental health problems – experiencing difficulties from food are often the result of, or can result in other mental health problems such as depression, self-harm, anxiety and feelings of worthlessness. • Social pressures such as images in the media, pressure to resemble peers It is important to remember that eating disorders are complicated. They are difficult for others to understand, but often even more difficult for the person suffering to understand. There is never one single cause of and eating disorder that can be easily fixed. But the key is to try to talk about any feelings of anxiety you are feeling towards food, it always help to get things out in the open. So remember to talk to someone you can trust, friends, family and the college welfare team are always around to listen. Look out for your friends, if you notice a friend seems to be struggling, give them an opportunity to talk to you. Having someone to listen may make all the difference to starting to understand problems with eating before they spiral out of control. “The hardest thing I've found suffering with Mental Illness is how misunderstood it is. When I was 15 I became ill with anorexia which saw my weight plummet to 41kg. All I wanted was to lose a bit of weight - I had no idea how tired I'd feel, how some people would start to distance themselves from me, how I would be reduced to a frail, fatigued shell too tired and lack-lustre to be happy anymore. At this point in time I didn't even accept I had a problem, I wasn't anorexic - those anonymous identities figurative miles away from me in the depths of tumblr - they were anorexic. I didn't want to be associated with something which for me back then was so taboo. With help from friends and

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family I eventually became aware of the treacherous path I was on, and bit by bit they got me back on track.I put on some weight and people seemed happy with that - however anorexia isn't about weight, it's about the whole mentality behind it, yes putting on weight is good, but with no therapy or other help behind it probability of relapsing is high. Needless to say I did go back and soon developed a self-harm habit, anxiety with frequent panic attacks, and depression, and, at one point was seeing three different therapists at one time. The hardest thing out of all that was the fear of being unable to talk about it; the fear of being judged. Constantly hiding scars, always making excuses for unexplained absences from classes or social events and having to hide myself in episodes of uncontrollable crying is exhausting – and it’s something so many people have to deal with. The scar on my left arm that I’ve probably told so many of you was a straightener burn? Well at least you know now. Everyone has their own issues, mine just happens to be low serotonin! So I think the moral of this tale is that mental health problems are nothing to be afraid of – they’re illnesses just like any other. Unfortunately due to their nature they’re harder to get our heads around, but the more we talk about and the more they’re understood, the better. Some amusing FAQs: But how can you be depressed? You seem so happy all the time! *Sigh* Just because I'm depressed it doesn't mean that I'm constantly shut up in my room lamenting the world. There are many different scales of depression and it affects people in different ways. For me, it was very much up and down and it hit hardest at night. Besides, I'm an excellent actress. But why don't you just eat? You must be so hungry! Oh how I wish I could just eat! Amusingly though, when I was anorexic I actually stopped getting hungry after a while. When I told this to my therapist she gave me this explanation: basically back in caveman times when you had to hunt for food, hunger signals were obviously go get food signals. When it got to the point where you no longer got hunger signals it basically meant your body was so deficient of energy that it wasn't worth the risk of spending a bit of energy to go and find food...(oops.) FINAL NOTE: I do not intend to offend anyone with my slightly light hearted attitude in certain parts of what I've written. Mental Health is a very serious matter but as someone who's a sufferer I actually think this type of approach is a good way to stay positive and get it spoken about.”

Lucy Brierley

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Anxiety Anxiety is, in a nutshell, the feeling of stress and panic. It is our body’s way of showing signs of feeling threatened or pressured. The majority of people experience anxiety when they are faced with a challenging situation such as an exam or interview. This type of short-term anxiety can be useful, feeling nervous before an exam can make you more alert and boost your performance. However, if you are overwhelmed by these feelings, your ability to concentrate will be reduced. If anxiety stays at a high level for a long time, it can become difficult to deal with everyday life. With severe anxiety, you may feel completely out of control and powerless over your situation, if these feelings take over, you may experience a panic attack. Panic attacks can be terrifying experiences and are exaggerations of the body’s natural response to fear or stress. Panic attacks are characterized by the rapid build-up of overpowering sensations, such as a pounding heartbeat, feeling faint, sweating, nausea, breathing discomfort, loss of control and shaky limbs. Panic attacks come on very quickly and most last for between 5 and 20 minutes. Effects of Anxiety: • Being fearful, irritable and unable to relax or concentrate • Being pessimistic • Increased muscular tension causing discomfort and headaches • Light-headedness and shaky • Pounding heart • Nausea and sickness • Urgent need to go to the toilet, ‘butterflies’ in your stomach • Fear with tension and a lack of sleep can weaken your immune system and make you more prone to infection • Digestive difficulties • Depression

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Dealing with Anxiety • Breathing and relaxation techniques • Assertiveness training – learn how to stand up for yourself whilst taking into account other’s opinions. • Complementary therapies – for example yoga, meditation or even treating yourself to a massage. Check out Yoga and Pilates in the Undie every Sunday at 10am! • A healthy lifestyle – Exercise can help you cope with anxiety and feelings of tension, and may help you feel better. Eating a healthy diet and avoiding stimulants such as coffee, cigarette and alcohol. • Talking – Chat to a family member or a friend about your worries. Contact a member of the welfare team or come to a drop-in!

“A panic attack can come at any time, whether provoked or completely out of the blue. When I had my first one I was in year eleven and was experiencing general anxiety problems but I chose to keep it as my secret, feeling too embarrassed to tell anyone. It wasn’t until Upper Sixth that I had my next one. I had recently lost two stone in the space of six weeks due to a prolonged period of intense anxiety problems, and had reached breaking point. It was at this point that I finally spoke to someone. My clothes no longer fitted me, my energy levels were incredibly low, my grades were suffering and most importantly I was incredibly unhappy. Luckily I felt able to speak to my family and was immediately taken to see someone. I turned down further professional support services because as soon as I was in the therapist’s office I immediately shut down again. I instead chose to confide in my close friends and siblings as it felt less pressurised, and even now, when I feel low, experience sleep paralysis or just generally feel anxious, I will chat to a loved one. I cannot emphasise enough how important it is to reach out to someone when you experience a mental health problem. I allowed myself to be alone with mine for far too long and it was beginning to have a severe effect on both my mental and physical health. Although difficult to begin with, as soon as I opened up I started regaining lost weight and my personality returned. I won’t say that it will completely go away; even now I have an occasional attack and am a terrible sleeper, but I am happy, healthy and I feel in control. So please don’t suffer on your own: it can be incredibly lonely, frightening and unnecessary.”

Sarah Westlake

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OBsessive compulsive disorder 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. It comes in various forms, and symptoms can range from mild to severe. 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. What is an obsession? An obsession is an unwanted or unpleasant thought, image or urge that repeatedly enters a person’s mind, causing feelings of anxiety, disgust or unease. What is a compulsion? A compulsion is a repetitive behaviour or mental act that someone feels they need to carry out to try to temporarily relieve the unpleasant feelings brought on by the obsessive thought. OCD is heavily misrepresented at university and in the wider press, as it tends to be stereotypically associated with feeling the need to keep your room tidy or repeatedly wash your hands, for example. However, it actually runs a lot deeper than that and can be absolutely exhausting to live with, taking over your life completely. What causes OCD? Despite much research being carried out into OCD, the exact cause of the condition has not yet been identified. However, a number of different factors that may play a role in developing the condition have been suggested: • Genetics – research suggests that OCD may be the result of certain inherited genes the affect the development of the brain. • Brain differences – brain-imaging studies have shown some people with OCD

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have differences in certain parts of their brain, including increased activity and blood flow, and a lack of the brain chemical serotonin. The areas of the brain affected deal with strong emotions and how we respond to these emotions. • Serotonin – this brain chemical transmits information from one brain cell to another and is known as a neurotransmitter. Serotonin is responsible for regulating a number of the body’s functions, including mood, anxiety, memory and sleep. From studies, it appears that some people with the condition appear to have decreased levels of the chemical in their brain. • Life events – OCD may be more common in people with a history of having experienced emotional, physical or sexual abuse, neglect, social isolation, teasing or bullying. An important life event, such as bereavement, family break-up, a new job, pregnancy or childbirth, may also trigger OCD in people. • Personality – if you are a neat, meticulous, methodical person with high standards – a so-called “perfectionist” – you may be more likely to develop the condition. Dealing with OCD Self-help materials – OCD-UK have a list of popular self-help books and some free computerised cognitive behaviour therapy (CBT) programmes available Peer-support groups – Help you feel less isolated by meeting up with people who have gone through the same sort of experiences as you Relaxation and mindfulness techniques Physical activities – join one of Castle’s numerous sports teams, no experience needed, or take part in Aerobics in the Undie every Wednesday and Saturday. Talking - Chat to a family member or a friend about your worries. Contact a member of the welfare team or come to a drop-in! “I used to suffer from OCD very badly, caused by an early experience of bereavement in my life. I still get it nowadays but never as severely. It’s a difficult condition to explain, but essentially imagine having a little voice in your head telling you that if you don’t give in to its orders, something bad will happen. For example, six has always been a lucky number of mine, so I used to have to turn the light switch on and off six times in a row before leaving a room, or en route to a language oral exam might have to walk up and down Elvet bridge six times before deciding I could move on and get to my exam! It was draining, frustrating and, at times, awkward!”

George Rexstrew

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BIpolar Bipolar disorder is a severe mental health illness characterised by significant mood swings including manic highs and depressive lows. The majority of individuals with bipolar experience alternating episodes of mania and depression. Manic Episodes Symptoms may include: • Feeling euphoric – excessively ‘high' • Restlessness and a reduced need for sleep • Extreme irritability • Talking very fast • Lack of concentration • Having a lot of energy • Sense of own importance • Poor judgement • Excessive and inappropriate spending • Increased sexual drive • Risky behaviour • Misusing drugs or alcohol • Aggressive behaviour You may not be aware of the changes in your attitude or behaviour while you are having a manic episode. However, after a manic phase is over, you may be shocked at what you have done and the effect that it has had.

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Depressive Episodes Symptoms may include: • Sense of hopelessness • Feeling emotionally empty • Feeling guilty or feeling worthless • Chronic fatigue and difficulty sleeping or sleeping too much • Weight loss or gain • Changes in appetite • Loss of interest in daily life • Lack of concentration • Suicidal feelings

Dealing with Bipolar Bipolar affects every aspect of your life and your relationships, family and friends can all be put under stress. To understand and to manage the illness it is vital to seeks support from professionals but here are some things you can do yourself to help: • Checklists, mood diaries and exercises to help you recognise and control mood swings • Setting up and sticking to a daily routine • A healthy diet • Getting enough sleep • Gentle stress free activities • Complementary therapies

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HELPING YOURSELF Maintaining your mental wellbeing isn’t a silly as it sounds, nor as ominous, and it’s something which is important for everyone! There are many activities and things you can do both here in college and in Durham itself, which you may not have thought about, but that are both fun and relaxing. For example, it could be worth considering: 1. Keeping up that social life! ...whether it’s going to a society social (social members are always welcomed), enjoying chilled meal times, meeting a friend for coffee, planning a day trip with someone, catching up with an old friend or giving a relative a call… relaxing and taking time out to spend time with friends and family or to make new friends is really important. 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. For example, the Castle Community Action (CCA) projects are a really great way of socialising, not just with your peers but with members of the community too, and are often possible to get involved in mid-term or part way through the year. 2. Be active! – try a new activity in college or pick up that sport which you thought you didn’t have time for at the beginning of the year, whether it’s our very own castle Aerobics society or a university-wide society such as Hill Walking, there’s sure to be something that takes your fancy! What is more, getting out and about doing physical exercise, even just a little here and there, not only improves your mental well-being but also helps you stay physically healthy.

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3. Eat and drink well – Just because you’re a student doesn’t mean you can’t eat and drink reasonably healthily. Many snacks, alcohol and caffeine contain chemicals which can have negative effects on your mental well-being so it’s definitely worth making room for healthier food options and having a few days off alcohol. It is also really important to be aware of the potential negative effects of alcohol on depression, anxiety and other health problems. 4. Peer support … talking to people with similar experiences and feelings, people who are able to empathise, can be really helpful. If you are able to talk things through this can allow you to feel accepted as well as helping your self-confidence. Whilst friends, peers and family can be a great source of support, through some social networks or websites such as Mind (they have an online community called Elefriends which is worth looking at) it is possible to find people with similar experiences and feelings. Here in Durham we have an SCA group called Durham Minds (www.facebook.com/durhamminds) which could be a great way meet, chat and relax with people who are really understanding of you as an individual. Their weekly CREE groups create an atmosphere of mutual support and friendship, an environment where you can really be yourself. 5. Something called ecotherapy … why not try it? It basically means getting out and about, enjoying your surroundings and the gorgeous countryside that we have here in Durham. There are many walks out of Durham worth exploring, but perhaps also look out for the next Welfare walk as an opportunity not just to get out of the bubble that is Durham and Castle for a short period of time, but also to engage with like-minded people. 6. Try mindfulness? … It sounds odd, but this is essentially a fancy way of describing a therapeutic technique involving making yourself more aware of the present moment, the world around you and your feelings and thoughts. Engage your senses; appreciate the sunshine and blue sky, the mist hanging over the river, or even just how good college brunch is… Try and really notice and enjoy the little things, it genuinely can pick up your mood, but also can help you understand your own reactions and moods. There are many little things you can do to help your own mental well-being and many are possible to achieve if not within college, then in Durham itself. So why not try ecotherapy or even mindfulness, a new society or catch up with a friend you don’t spend enough time with over coffee, you may well find yourself feeling better as a result!

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“Struggles with mental health have been part of my life for as long as I can remember. I first was diagnosed with depression and severe anxiety at the age of six and have been on anti-depressants on and off ever since. A lot of my memories of primary school are being shunted around between child therapists, psychologists, psychiatrists, and school counsellors. I never really understood why all this had to happen to me, as I'd never really suffered - I came from a relatively affluent household with two married, loving, and hypereducated parents. I started to exist in a permanent state of shame and fear about the way I thought about things. I loathed all of primary and secondary school. More problems - bipolar disorder, dysthymia, anorexia, EDNOS, OCD, Asperger's, and ADHD to name a few - were thrown at me. I was already well ahead of my peers in school and quite recalcitrant and this only made me feel more bizarre. Teachers and mental health professionals tried to make me 'talk about my feelings' and 'participate with the group' but I only felt patronized, bored, and resentful. I learned to adapt a bit and found my niche, but still was consumed by bitterness of my 'defects'. My first year of uni started out better, but as I played around with my medication, grew worse quite quickly. By the end of Epiphany term, I'd lost about 20 pounds and had ceased to do work. My hair was falling out and I couldn't sleep due to terrible nightmares and constant panic attacks. I felt alone and confused. After an incident involving me cutting off my fingertips with a razor and then fainting in the marketplace, I decided I was absolutely fed up. I went to Eva and we began to formulate a plan. Over Easter, I worked with a GP and psychiatrist and began to get my physical health back in shape.

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I found a better antidepressant and started work with a cognitive behavioural therapist. I also stopped drinking, which, while intensely frustrating, made me feel infinitely better. Easter term was gruelling. By some divine miracle I made it through exams with a 2:1 and started to work with the counselling and disability service. I began to gain weight (which is actually surprisingly difficult) and feel better. It was a hard and slow process, but things eventually began to look up. Starting my second year, I was in a much better place. Though I had my ups and downs (and still do), I'm much more comfortable with who I am and how to cope. My mental illness doesn't define me - it's merely something to be managed like diabetes or asthma. I've built up a support team, restarted my social life and am getting a first now. For once, I'm actually enjoying being the intelligent weirdo I am. Considering how much this has dominated my life, I wish there were a 'quick fix'. Recovery is a long and gruelling process and I wouldn't wish it on anyone - but it's so much better than the alternative. I was able to make leaps and bounds because I had great support: College Office, Welfare, loving friends and family, Disability Services, my GP, my psychiatrist, my therapist, and the Counselling Service. I also chose not to let my depression (and whatever else I've got) define me, indeed to be rather open about it. Take charge of yourself, of who you are and find the legions of people who are willing to support you. (Sometimes they exist in the most unlikely places - shout out to the Oxfam Bookshop staff and Fabio the barista). Considering the number of times I contemplated suicide, contemplated the abyss, I am honoured and blessed to be where I am and, absolutely vomit-inducingly cliche as it is, it gets better.�

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Helping Family and friends You yourself may not be experiencing a mental health problem but a friend or family member may be and this can be difficult. Sometimes the small everyday things can make a big difference, so we’ve outlined some ideas as to how you might be able to go about being supportive: • SHOW your support: don’t be afraid to ask. The person may or may not want to talk about it, but just letting them know that you care and that they don’t need to avoid the issue with you is important. Even just spending time with the person can show that you care, whilst also helping you to understand what they are going through! • Ask HOW you can help: People need and want support at different times and in different ways so asking how you can help is good, whether a friend wants to exercise, which you could do together, or your roommate wants more sleep. Being accommodating and willing can be really helpful! • Open-mindedness: Try to avoid slip-off the tongue phrases like ‘Cheer up’, ‘I’m sure it’ll pass’ and ‘Pull yourself together’… whilst well intentioned these won’t help. Instead, try to be non-judgmental and listen. Often the person experiencing a mental health problem knows what is best for them, what is helpful and what is not. Be open-minded and receptive! • There’s more to a person than a mental health problem… bear in mind that a mental health problem is just one part of a person. People don’t want to be defined by this, so keep talking and engaging with the things you’ve always talked about. • Trust and respect: Having both of these between you and the person are very important for the building and maintaining of self-esteem, something that can be seriously damaged by mental health problems. A trusting and respectful relationship will also help you to cope. Hopefully be able to see your support having a positive impact!

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• Look after yourself: It can often be easier to be good at supporting someone if that role is shared by others. Finding someone to talk to about the situation can also be very helpful, be that a family member, friend or member of the welfare team, or even someone through another listening or advice-giving service. It’s important to remember that if you yourself become affected you’re less able to offer support, so be sure to look after yourself too! “Being six years younger than my brother, Oliver, I grew up believing it was perfectly normal and acceptable for us not to really get along. I was always the energetic, sporty and, in my mind, happy one. Oliver was the moody one who slept in late, stayed in his room and whose communication rarely strayed beyond monosyllabic grunts and closed remarks. It was just how things were and I was in no position to change them. I admired Oliver as my elder, but I also feared him. Scared of annoying him, I never dared ask what was wrong. Ignorant to the idea that people suffer from mental health issues, I never even considered there was anything wrong. Several years later and now in his early twenties, my brother contracted glandular fever, a symptom of which can be depression. I've never spoken to him about this, but I imagine that when described by the doctor, Oliver realised what he'd been feeling for years of his teenage life and a full diagnosis of depression was made. At the time I assumed this 'depression' was just a temporary emotional state, I assumed he'd feel better soon and it was simply occasional melancholy some people feel when they faced difficult problems. I decided to do a bit of research for myself and found out how wrong I had been. Gradually, everything started to make a lot more sense. The irritability, the anger, the hostility, the withdrawn behaviour were not parts of my brother's natural persona, but manifestations of his depression snowballing out of control. This diagnosis was a landmark in not only my brother's life, but all those close to him. With his own determination and with help from his family, friends and the NHS, Oliver's life turned in a new direction. He became more communicative, happier, he exercised more, challenged himself and showed genuine care and consideration for those around him. Now a marathon runner, a cyclist, a lover of festivals and of travelling, I see Oliver enjoying life. Now I truly admire Oliver, not simply for being my elder, but for being one of the strongest people I know. I have my brother back again. In his own words: “Mental health is one of those things few of us talk about, with fear, stigma or a sense of helplessness often blocking the path to help, and it’s something I know all too well. It doesn’t care for age, affluence, education or gender, and for sufferers, it can be crippling. But, with the right support and work, it’s something we can help work to not just improve, but also empower”

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MENTAL HEALTH SUPPORT SERVICES If you are worried about your safety and feel at risk of harming yourself please access help immediately through one of these contacts: NHS Your own GP during normal office hours, or out of hours service after the surgery has closed (Telephone: 111) Local Hospital Go to the Accident and Emergency Department of your local hospital. In emergency situation call 999 for Ambulance and/or Police Samaritans Samaritans offer confidential emotional support to anyone in crisis 24 hours/all week (National) 08457 90 90 90 (Durham) 0191 384 2727 (Drop-in service 9.30am - 9.00pm) 26 Sutton Street, Durham Email: jo@samaritans.org www.samaritans.org.uk CALM - Campaign against living miserably Helpline for young men (aged 15-35) who are depressed or suicidal or living in crisis Telephone: 0800 58 58 58 5.00pm - midnight -7 days per week www.thecalmzone.net

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Helpline Confidential emotional support and guidance Middlesbrough: Telephone: 0800 052 7350 6.00pm - 6.00am daily Stockton: Telephone: 0800 052 7349 6.00pm - 6.00am daily Email: timeonline@mentalhealthmatters.co.uk www.mentalhealthmatters.com PAPYRUS - Prevention of Young Suicide For practical advice on suicide prevent for people aged 35 and under HOPELineUK 0800 068 4141 Monday - Friday 10.00am - 5.00pm & 7.00pm - 10.00pm Weekends 2.00pm - 5.00pm www.papyrus-uk.org/ Other Support Services available to students: Welfare Team • A confidential listening service that allows you to come and talk to another student about anything that may be bothering you. • Provide sexual health products such as condoms and pregnancy tests, and can help you to get in contact with other services that may be helpful to you. • You can send us an email to castle.welfare@gmail.com this account is checked once a day by the Welfare Officer and will be responded to as soon as possible. • Drop-In sessions in G7 (garden stairs) every weekday 2-4pm with one of the members of the team • There are regular Skype drop-ins: (castle.welfare). • Welfare phone-line: able to answer your calls and texts from 9 o’clock in the morning to 9 o’clock at night. Call/text: 07852 609867

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College Chaplain Hannah Cleugh: hannah.cleugh@durham.ac.uk College Office: contact Eva, eva.schumacher-reid@durham.ac.uk Nightline: • A Confidential Listening and Information Service • Run for students by students • Open: 9pm until 7am every night of term • Telephone: 0191 334 6444 • Drop-In: Behind the Dun Cow Pub, Old Elvet • Online Chat: via website (9pm to 7am) • Website: https://www.dur.ac.uk/nightline/ • Email: nightline@durham.ac.uk Durham University Counselling Service • 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/work. • The Counselling Service is there to enable you to become more effective in your lives and overcome barriers to achieving your full potential. • Aims to help you to explore and understand more clearly the issues that concern you. • To decide whether counselling is right for you, visit: https://www.dur.ac.uk/counselling.service/students/counselling/ Making an appointment: You can call into the Counselling Service Department Reception: (Palatine Centre, Stockton Road, Durham DH13LE) and speak to Helen or Sarah Cogger directly Telephone: +44 (0) 191 334 2200 Email: counsel.service@durham.ac.uk

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Alternatively, use the Drop in Service • The Counselling Service operates a Drop in Service at Durham Campus during term time. • This service enables students to access support in an emergency. • Drop in appointments are for 30 minutes • The Drop in Service is available 9.00am every weekday - as this is on a first come first served basis it is vital that you arrive at 9.00am If you need out of hours support please contact Samaritans on 08457 90 90 90 • Opening hours are 9.00 am - 5.00 pm Monday - Friday Evening Counselling Service: • The evening service operates at peak times during term-time and is available Monday and Tuesday evening at both Durham and Stockton Campus

Online: The following websites have lots of useful information on mental health: 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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The taboo surrounding mental health often makes it difficult to talk about these issues, so a huge thank you to all the Castle students who have challenged this by sharing their own experiences. Hopefully, these stories will open up the discussion surrounding mental health and increase our understanding. Thank you to the Welfare team for all their hard work in researching mental health and putting this booklet together. Thank you very much to Celia Durkan for all her help with the design of this booklet.

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