Castle Guide to Mental Health by Kirsten Ash

The Castle Guide to Mental Health

Contents 2

A letter from the Editor

3 Introduction 4 Depression 7

Seasonal Affective Disorder (SAD)

10 Anxiety 14 Eating problems and disorders 20 Obsessive Compulsive Disorder 22 Bipolar Disorder 26 Post-Traumatic Stress Disorder 27 Helping yourself 28 Caring for others 31 Support Services

A Letter from the Editor Dear Castle, We are lucky to live in a day and age where the fight against the stigma has begun. There are so many support servics available, from your local GP to specialised therapy, but we still have a long way to go. The best way of tackling the major issues in mental health is by educating people into what it actually entails. That’s exactly what this booklet is going to do for you. Starting the conversation on mental health not only teaches people about the facts but also enables sufferers to open up and get help. Mental illnesses and disorders are pretty much invisible, so the main way of understanding what someone is going through is by letting them explain it to you. Every person’s story in here is different, with a variety of symptoms, backgrounds and diagnoses. I wanted to do this to help people open up, and I practice what I preach. I first spoke about my mental health in college in 2nd Year, just before I had to drop out on concession leave for depression. Despite this, it’s still not easy to talk. I recently sufffered from an episode of psychosis, which was the first time in a while I didn’t want to tell anyone. Now I have a crisis care team and weekly doctor’s appointments, and find that the more I talk, the easier it gets.

A few house rules:

Many people have specified that they wish to remain anonymous. If you think you recognise anybody from what they have written, keep it to yourself please! What we are aiming for is giving people the choice to divulge. If you don’t want to talk about your issues, that doesn’t make you any more or less brave than anyone else. If people don’t wish to talk to you, or if you don’t wish to talk to them, that’s okay! Trigger warning: this booklet has stories in that can be quite difficult to read, covering subjects such as self harm and suicide. These will be indicated. Love, Kirsten Ash Campaigns Officer

Introduction to Mental Health What is Mental Health?

Mental health can affect the way that you think, feel and behave. They affect around one in four people in Britain, and range from common mental health problems, such as depression and anxiety, to more rare problems such as schizophrenia and bipolar disorder. A mental health problem can feel just as bad, or worse, as any other physical illness - only you cannot see it. There are a lot of different approaches to how mental health problems should be diagnosed, what causes them, and which treatments are most effective. And, unfortunately, there is still widespread stigma and discimination towards people with mental health problems, and misunderstanding about what different diagnoses mean. However, despite these challenges, it is possible to recover from a mental health problem and live a productive and fulfilling life.

Cultural Perspectives on Mental Health Problems

Different cultures have different approaches to mental health and mental illness. Most Western countries agree on a similar set of clinical diagnoses and treatments for mental health problems. However, cultures in which there are other traditions or beliefs may not use these terms. Depending on the culture you grew up in, you might be more familiar with terms like ‘poor emotional health’ or ‘poor emotional wellbeing’ to describe your experiences, and have different ideas on how best to cope. And in many cultures, mental health is closely associated with religious or spiritual life. How you understand your own mental health, and any problems you experience, will be personal to you. - Mind (www.mind.org.uk)

Depression We often use the expression ‘I feel depressed’ when we’re 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 depressed in the medical sense of the term. In it’s 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, major depression (clinical depression) can be life-threatening, because it can make you feel suicidal or simply give 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.

Phsyical - 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. - Mind (www.mind.org.uk)

“ Sometimes you just feel down and you can’t explain or even understand why. Sometimes just the tiniest little thing gets to you, or lots of things pile up because you don’t know what to do about them, and you’re sent into utter meltdown. There are days when you want to stay in bed all day and not talk to or see anyone. You just feel guilty as if you’re bringing those around you, the people you love, down with you. You might think all your problems are your own, no one else deserves to have them inflicted upon them too. You might think you don’t have the right to feel as you do, people are going through much worse and getting on with their lives right? But that’s not true, you matter and you’re allowed to worry about things and get upset. And do you know what? People care too. Opening up about depression and getting help was one of the best decisions I’ve ever made. I was embarrassed, ashamed at first, but talking to people showed me I’m not alone. It’s a common problem that you don’t have to suffer in silence with. I promise there’s light at the end of it all, and the best way to move towards it is opening up to someone. I know it’s hard, but there are people there for you, who care and will help you through it. People who will make you smile and laugh, who will listen to you, who won’t judge you and will still love you and see you for you, not the illness which they know you’ll overcome. Don’t be afraid to ask for a hug, or a shoulder to cry on, don’t be alone. Be brave and ask for help, and you’ll be surprised how happy people are to give it to you!” - Anonymous “Depression, for me, is like a storm cloud. It’s heavy, overbearing, forever changing, terrifying and a parasite. But you’re the only one that can see it. Sometimes it surrounds you with such force you can’t move, just wait. Those are the bad days. Sometimes it settles by your feet and your head is above the clouds, able to take in the sunshine and breathe in the clarity. Those are the good days. There are more good days than bad now, but there definitely was a point where I didn’t think I’d survive the storm and was trying to find a way out, by whatever means possible. I was one of the lucky ones.” - Anonymous

Trigger warning: suicidal thoughts.

“Everybody has probably read Harry Potter. In there, what most people do not notice, is one of the best descriptions of depression in modern literature. ‘Get too near a Dementor and every good feeling, every happy memory will be sucked out of you. If it can, the Dementor will feed on you long enough to reduce you to something like itself... soulless and evil. You will be left

with nothing but the worst experiences of your life’. Replace Dementor with depression and you are pretty close to what it’s like to experience depresson. It is a feeling, not just understanble by anyone who has not experienced it. It is not just sadness, it is the absence of all happiness, all reason to live. And the worst thing: it just hits you, without reason, without warning. The helplessness is nearly as bad as the feeling itself. Moreover, no one around you would understand you. No one really understands, why you suddenly stop hanging around, why you suddenly stop being fun - because they do not understand the pain. I myself was diagnosed over two years ago with clinical depression, being on medication quite recently. The medication helps, but the side effects kill you slowly and the withdrawal, once stopped, just makes you feel like a drug addict. The worst part about being diagnosed is probably not even the illness itself, even though the pain is indescribable, but the inability of anyone, who has not experienced it themselves, to understand your pain. You start by telling your parents and then you realise that they just don’t understand, you decide not to make it public in front of your friends, which forces you to come up with poor excuses every time, you just cannot move, because your illness is forcing you down. The illness itself is bad enough, the stigma makes it worse. The fear of people judging you as weak forces many of us to remain anonymous. Therefore, sometimes I just wish I had something visible just so people could support me in my suffering; so I wouldn’t have to hide in my room every time my illness tackles me down. There are moments, when you lie in your bed, evaluating to kill yourself. Life appears to be pointless. Suddenly you catch yourself avoiding high bridges, busy roads, train stations... just to not be tempted by the relief it promises. David Foster Wallace: “The person in whom its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.” I strongly advise anyone interested to watch the TED talks by Andre Solomon. He is able to capture the pain of depression in words.” - Anonymous

‘SAD’ Seasonal Depression Seasonal Affective Disorder (SAD) is a form of depression that people experience at a particular time of the 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 in 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 affect on your mood and energy loevels, and lead to symptoms of depression that have a significant impact on your day-to-day life. - Mind (www.mind.org.uk) “I have suffered from severe Seasonal Affective Disorder (SAD) for the past 4 years. This means that between September and May I am very susceptible to suffering from depression. Alongside this, I feel exhausted, suffer from anxiety, feel like overeating and just want to hibernate until winter is over. I went to see my doctor who told me use light therapy in the form of a light box in my bedroom, which has made such a big difference on my mood. Although it isn’t always a quick solution. I have tried medication, but I find that the most effective method for me is Cognitive Behavioural Therapy and I always like to keep a little book about mindfulness and CBT close to me so I can dip in and out if I need. I think that among those who are aware of SAD, it is not considered as severe as other mental illnesses, despite the fact that it is estimated around 2 million people suffer from it during the winter months, to varying levels of severity. The effects of it are exactly the same as depression so it should be treated the same way. It is a real illness and if you think you have it is so important to tell a doctor. I can’t overestimate how glad I am that I took the leap of faith to see my doctor. My next step is to tell my friends in Durham my biggest regret was not telling them. I have confided in friends from home, in particular my closest friend at Exeter, also a sufferer of depression. He is only a phone call away when times are tough and to be completely honest it is so grounding having someone who is impartial to everything going on around me in Durham. Still, I would like to give some explanation to my housemates for why I have been such a grump this winter!” - Anonymous

TRIGGER WARNING - Suicide description. Names and identifiers have not been disclosed sue to the Data Protection Act. If anyone wishes to discuss the content of the story do not hesitate to contact the welfare team. “Alice and Tim were perfect couple. I was actually seeing Tim for about two months when I introduced him to my new friend Alice. They were naturally suited for each other, I felt proud for connecting them. Her parents loved her; she led colourful life, full of adventures and endorsements. But do not get me wrong; she was far from being ideal. For example, she would throw a princess-worthy tantrum over the colour of the shoes that I wore, or how quickly Tim picks up the phone. I did not mind her tantrums because I saw a bigger part of her; understood her insecurities better and I guess it was not as directed onto me as it was on Tim. I had to be peace maker on many occasions. On one night, tantrum exploded into an uncontrollable fight. Both were angry, not willing to listen or understand. Tim walked out angrily slamming the door behind him, and Alice threw a vase into that door. It was Alice’s dad celebration dinner, with Tim’s family was also present – needless to describe how awkward the rest of the evening was. I stayed with Alice for a sleepover to help her to handle the consequences. But weirdly, she seemed to be fine; and I would say even, in a twisted way, she enjoyed that argument. The next morning I had to leave to the countryside to see my grandparents, and Alice’s parents had a business trip. I asked her if she wants me to stay around for longer, because I did not want her to be alone and upset. But she assured me that she would ring me if she needs me. Upon my return I called Alice, but she did not pick up the phone. I just assumed she was busy and will call me back later. When she didn’t, I rang her again with no success. Slightly puzzled, I decided to call Tim to see whether he knows what is happening. Turned out, that Tim has not spoken to Alice since he left the dinner party. He wanted to give her some time to cool off and was busy planning proposal meal later today. He asked me if I want to come with him to pick up Alice, and without second thoughts I excitedly agreed and we went. When we got to her house, it was abandoned. The weekend papers were not picked up from the pouch, leaves not taken away and no lights at all in the house. We rang the bell a few times, but the only response was the weak bark of the poodle. When I rang up Alice, I could hear her phone ringing in the house, followed by the “discharged battery” sound and then silence. Trying not to panic we decided to open the door and investigate. ... cont.

Tim opened the door and went into the kitchen to let the dog out. Meanwhile, I wondered towards the stairs, and I saw Alice, hanging from the second’s floor railing. What happened next could not be forgotten or accurately described. I screamed, heard Tim rushing towards me. I wanted to hold onto the wall, stop Tim from looking and rush to Alice’s body at the same time. I remember seeing poodle approaching me in a slow motion. I saw Tim’s face in a grimace and loosing its colour. The moment after, Tim is falling onto me, fainted, the dog howling, a sound of glass vase being shattered and above all of that – Alice. Later there was a rather depressing kaleidoscope of events and feelings: ambulance, policeman, calling parents to tell the news, funeral, guilt feeling, comforting Tim. You would think that finding Alice’s body was the hardest part in the whole situation. What proved to be the hardest is to comfort people that Alice left behind: her parents, her friends, Tim. I would say that Tim was the hardest for me to manage. Even though what we lived through was horrible, I thankfully managed to recover from it fairly quickly. It also helped that I decided to do short training in counseling service; it helped to put things into perspective and educated me on how to approach people who experienced loss. Tim was devastated. His grief quickly became a part of him, and it changed him. The only person he would want to speak to would be me. He would go on for hours re-living life with Alice. He would talk to her when he was happy or upset. Sometimes it even felt like he was obsessed with Alice, and it almost felt like he was trying to rub some of it on me too. On one of the nights, Tim was mourning the fact that he will never get a chance to marry Alice. In this little sentence I saw a possible way of “curing” Tim. I simply suggested, that we do hold a small ceremony, and that he can marry Alice with his heart. Uplifted, he took this idea with great joy and for the first time in weeks I saw genuine smile on his face. We held a small ceremony of Tim “marrying Alice”; with her parents and some close friends present. After that night, it felt like they finally entered road of recovery. If you are living through similar experience, or you know someone who has suicidal thoughts, if you need some tips on how to care for someone in such situation or just want to chat – please do email me or knock on my door at any time of day or night. From my experience, talking about your problems (or if you worried about someone else) does make a dramatic difference. Life is a miracle, and every day is a gift. So in a way it does not matter how you choose to live through it; what is important that you do.” - Galina Badalova

Galina is kindly willing to be contacted if anyone wishes to talk to her.

Anxiety Anxiety is a word we use to describe feelings of unease, worry and fear. It incorporates both the emotions and the physical sensations we might experience when we are worried or nervous about something. Although we usually find it unpleasant, anxiety is related to the ‘fight or flight’ response - our normal biological reaction to feeling threatened.

When does anxiety become 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 anxeity 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 diagnosis of a specific anxiety disorder.

Symptoms Physical - nausea

- tense muscles and headaches - pins and needles - lightheadedness or dizziness - faster breathing - sweating or hot flushes - fast, thumping or irregular heart beat - raised blood pressure - difficulty sleeping - needing the toilet more frequently, or less frequently - churning in the stomach - panic attacks

Psychological - feeling tense, nervous and on edge - a sense of dread or fearing the worst - feeling like the world is speeding up or slowing down - feeling like other people can see you’re anxious and are looking at you - feeling your mind is really busy with thoughts - dwelling on negative experiences or rumination - numbness - inability to concentrate - Mind (www.mind.org.uk)

“I’m Emma, a third year biologist and about 18 months ago my experiences with anxiety and depression began. It’s hard to pin point the exact time and place- I’ve always been quite highly strung and had very high standards of myself. But during my time at university what started as barely noticeable personality traits developed into debilitating disorders. For most of my life I have supported lots of the people around me and I was proud of my strength and resilience. At school I’d helped one very close friend through severe suicidal and psychotic episodes. Then in the first term of my second year, already under intense pressures from my course, another friend from home’s depression took a turn for the worst. Most days I’d be sat on Facebook until the early hours of the morning trying to help her through crises or be woken up in the middle of the night by terrifying phone calls. On top of this my sister, with whom I am very close, was going through episodes of psychosis and severe depression. She’d sleep all night and all day, getting up to make a cup of tea would exhaust her, going into uni was out of the question. Occasionally, she’d black out and suddenly come round on the other side of Glasgow having no idea how she’d got there. At the time I was smiling and getting my work done. I’m only realising now that underneath the surface I was not okay. Depression is like drowning really slowly. There’s this blurry, suffocating cloud between you and everyone else creating a sudden static space which holds you back from the people and things you love. I took on a heavy and stubborn bad mood; I didn’t want anything. I’d cry every night about nothing and everything at the same time. The bulimia I’d briefly experienced at school surfaced again and saw me mentally punishing myself over what I ate while obsessing over exercise. In the summer between 2nd and 3rd year I had my first panic attack. I still remember it very clearly- it was like in films where everything spirals into black, I couldn’t breathe and was shaking uncontrollably, honestly I thought I was dying. When it passed I looked as though I’d just run 5k. I remember promising myself that it wouldn’t happen again but unfortunately this was just the start. Over the next few months my anxiety got worse and worse, complemented by a furious disappointment in myself. I’d have panic attacks most days, sometimes I’d just spend whole days preparing myself for them. If depression is like drowning, anxiety is like your air supply escaping and bubbling frantically to the surface. Everything around me felt so overwhelming, I’ve had panic attacks over not being able to plug in my hairdryer or getting lost on the way to a friend’s house. During my worst attack I had convulsions- my arms and legs were thrashing about and when I tried to stand up I just fell over and couldn’t move. ... cont.

I nearly didn’t come back for third year. I’m glad I did though and I promised lots of people I’d make use of the support network here. I went to see Eva in Fresher’s week and went to the counselling service. I’ve always been quite emotionally vocal, so although these were of great comfort and support, there was no big breakthrough. Undoubtedly though, all the love and support I’ve received have made this year so much easier (thank you everyone!) and finally, in February I went and to the Doctors. I had plenty of reservations about medication but I can honestly say they have made a real difference. It’s like I’ve just woken up; surfaced from the deepest sleep. I can suddenly feel the good and have started to not care about the bad. It’s amazing how much time I have too now I’m not wasting it obsessing over details or staring at walls. There are, of course, downsides but they’re outweighed by feeling like a normal person again. I wrote this article because I genuinely believe if I’d had less of an ‘us and them’ attitude towards mental health I could have saved myself a great deal of harm. I was clinging onto the image I had of somebody who had depression and it didn’t look like me. In a weird way I didn’t feel special enough to need help, it was all just me being silly and should get over it. When I first went to Eva I was caught in the middle of desperately wanting to be taken seriously and not thinking I actually had a problem. I wouldn’t say my story is particularly extraordinary but neither are mental health issues – there should be no stigma and no shame. If any of this sounds familiar I urge you to be brave and seek help, things can and will get better!” - Emma Walker “One time my mum had to pick me up from Durham, from home in the Midlands, at the end of term because my anxiety was too bad to get on the train. Things I worried about included: somebody already sitting in my assigned seat, the train being really busy, having a panic attack in front of everyone, train delays and the train crashing. I wasted £80. That pretty much sums anxiety up for me. It’s not logical, but it’s very real. It wastes your time, it wastes your money, and it seriously gets in the way of being able to live your life and do what you want to do. I do feel a lot of shame associated with my anxiety, because you realise how silly the worries are. Unfortunately your brain doesn’t always listen to your own common sense, and you have to have patience with yourself, and know that it’s not always going to be that way.” - Anonymous

“Anxiety cannot be explained easily so I’ve always described it metaphorically. It’s like being asked to keep your hand against the surface of a hot iron that is burning you. Your reflex action would be to remove your hand in order to protect yourself; of course it would be unimaginable for you to be able to keep it there. But imagine being the only person that can’t keep your hand there; no one else is being burnt, or feels pain from having their hand against the hot iron. Anxiety is a similar case. Others don’t feel the discomfort from the situations that trigger your anxiety (such as having to speak in front of a small group of people or maybe just sitting in the Castle at lunch time). They manage to live through these situations everyday yet you can’t help but avoid them. It’s the most isolating feeling in the world.” - Anonymous “Having suffered with anxiety for over 10 years, it has only recently became apparent to me how much of a consuming illness it is. Anxiety in particular, people consider as just ‘nerves’ but maybe slightly more dramatic, yet it isn’t just nerves at all. Anxiety for those with an anxiety disorder isn’t something that only occurs when something scary is happening, it may be triggered by the littlest of things when the person is sat in their home not doing anything fearful. For me, when I am experiencing anxiety at its height, I feel as those bad things are going to happen and sometimes as though im going to die and there’s no way out. Anxiety consumes every bit of you. I think it should be recognised that anxiety is a lot more than just heightened nerves, it’s an illness which can drastically change someone’s life. For me, I struggle to go places on my own due to anxiety. I feel as those I may see people I know and I don’t want to be see on my own as people may judge me. It’s about time we recognised anxiety as what it really is.” - Anonymous

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 punding 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.

Eating Problems and Disorders Food plays an important part in our lives, and most of us will spend time thinking about what we eat. Our relationship with food often changes sometimes we may try to eat more healthily, have cravings, eat too much or lose our appetite. Changing your eating habits every now and again like this is normal, and doesn’t need to worry you. However, if you aren’t eating a regular balanced diet over a longer period of time, it could start to become a problem for you. Having an eating problem can be very hard to cope with but it’s important to understand that eating probelsm 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. Focusing on food can be a way of disguising these problems, even from yourself. Because eating problems can noticeably affect your body, you may feel that people around you focus mainly on your actions, or on the physical impact they have. But you may feel that your problem is more complicated than the people around you realise. - Mind (www.mind.org.uk)

Types of eating disorders

Bulimia nervosa - one of the most common. You may eat large amounts of food in one go (bingeing). You may then feel ashamed and want to get rid of it (purging). Anorexia nervosa - You don’t allow yourself to eat enough food to get the energy and nutrition you need to stay physically healthy. People tend to assume it’s about slimming down, but it’s often connected to low self-esteem, negative self image and feelings of intense distress. Binge eating disorder - You might feel like you can’t stop yourself from eating, even if you want to. Sometimes described as a food addiction or compulsive eating. Food may be used to mask feelings or for emotional support. EDNOS (eating disorder not otherwise specified) - a diagnosis becoming much more common. You meet some but not all of the criteria for an eating disorder like bulimia or anorexia. This is not less severe than other diagnoses, and can be more confusing to deal with. - see Mind (mind.org.uk) for more in-depth descriptions

“Eating disorders are one of the most misunderstood mental illnesses. Friends and family still struggle to understand what exactly it was that I experienced so I’ll try to explain it as best as I can. Anorexia and bulimia have been a part of my life for nearly 8 years now. In the media, its always a girl who thinks she’s fat that decides the lose weight but takes it too far and becomes ‘anorexic’. Undoubtedly weight comes into it, but for me, anorexia was about control, a coping mechanism for anxiety and also a form of self-harm. Things at home were manic and out of control so I used restricting my food intake and over-exercising as a way of control. I thought I was powerful but my perspective became warped and I was no longer in control. The number on the scale had to keep going down; I became emaciated and couldn’t sit down without being in pain. My hair fell out, my skin was papery and cold, and my body didn’t develop, with a BMI of 13.5, which was well under the marker for being underweight (15). Starving meant that I couldn’t concentrate at school and it also led to raging binges, which would lead to overwhelming guilt and panic, so I would make myself sick. This was extremely painful and emotionally draining. This is how I got caught in the self-destructive cycle of binging and purging, also known as bulimia. I lost many friends by isolating myself with my disease. It is so difficult to be a friend to someone with an eating disorder. I lied, I pushed them away in an effort to protect my deceitful disease. I so thankful for those who stuck by me, and saw that I needed help. If you know someone with an eating disorder, please do not comment on their appearance - express concerns about their well-being, as eating disorders come in various guises. At the peak of my suffering from bulimia, I was actually a ‘healthy’ weight, and any comments on my appearance had a negative impact on my recovery. Recovery from anorexia and bulimia has been the hardest thing I have ever had to do. It doesn’t happen overnight. I had to learn how to be ‘myself ’ without the diseases, had to learn how to cope with my anxiety without harming myself and have had to learn how to eat properly again. It had been three years since I have officially ‘recovered’ from my eating disorders, but I still have my bad days; I can still be obsessive with food, still refuse to eat certain things and once or twice a year slip up with a binge/purge episode. But I can honestly say I have come along way. Living with an eating disorder is a miserable existence, that I would not wish on anyone. The most difficult thing is seeking help - eating disorders are deceitful by nature and are secretive illnesses - but its the biggest step you can take to freedom.” - Anonymous

“In second year, after having body insecurities throughout my childhood I decided to try and tone up, eat clean and get the body that I wanted. As a liver out I thought it would be the perfect opportunity to take control of my diet as I would be able to cook for myself and buy my own food. I also joined the gym and continued rowing. As I started noticing weight loss I was inspired to continue, I followed multiple fitness accounts on Instagram and became really particular about what I was eating, I didn’t allow myself any fatty foods, I drank litres of water to dispel hunger, I ate mostly raw food and drank tonnes of green tea. This went on throughout the year and I saw results that I was pleased with. Friends commented on my weight and many asked if I was ok, I even had friends take me to one side and ask if I was being too controlling about food, whether I had taken things too far, but I pushed these people away and said I was fine and that I would try and be less controlling, but I ignored them and continued. Eating habits stopped my social life, I didn’t like to go to events where there would be ‘bad’ foods or alcohol. At the back of my mind I knew they might be right but I was happy with the way I looked and I didn’t want to gain any fat ever again. I went to the gym every day and developed a mindset that I had to burn off anything I ate. My BMI was marked at dangerously low and I felt like this was an acheivement. At the end of summer term I headed straight off on my year abroad seeing my parents for only one day, when they saw me they were shocked and worried but I had already flown off to France for a summer job, and honestly I was relieved not to go home to have to deal with their comments. My routine continued over summer and my parents were so worried that they flew out to France and made me talk to them about it. When I eventually came home in September I went to see a councillor and tried to get to the bottom of the problem, talking about where the insecurities came from, and how to think about foods not as good and bad foods, to have more of a balanced approach. Throughout the rest of my year abroad, I got a little better, I was more relaxed and started to eat more in general, even if it was only healthy food - I ate larger quantities. However it still had a big impact on socialising, especially in Spain where there is a crazy amount of food that I considered to be ‘bad’. It actually made me feel scared thinking about it, as crazy as that sounds. Gradually I relaxed a bit over time, and as I got happier as a person, I think from making good friends and enjoying Spanish life, I also felt ready to talk to people about it and that helped too. Now I am a lot better, I have big portions but I still avoid certain foods completely, and go to the gym a lot. It’s something that takes time, I’ve only recently been able to admit that I had a disorder, and when I see photos of me two years ago it shocks me. ..... cont.

Talking definitely helps but only when people are ready, I also think its important not to comment on people’s weight ever, whether positive or negative, because you don’t know what is going on inside and what impact that could potentially have.” - Anonymous “I literally never thought I would have a problem with mental illness. I am sporty, loud and friendly. Depression was something that happened to emo teens and lonely old people of which I was neither. Mine was triggered, I think, by threat of failure and rising stress levels. However, it could have come on without these triggers and it remains regardless of any relief of outside pressures. Eating disorders were things celebrities had and anorexics were people who were desperate to be model thin. I didn’t want to be scary thin but I needed a way to combat the complete lack of control I felt as a result of the anxiety and depression. So as a result of the constant media and general young adult focus on calorie counting and eating ‘clean’ (Instagram has a lot to answer for!) I chose that as a means of gaining back control. I ate less and less and exercised obsessively so that the numbers kept going down. I didn’t want to do it. I wanted to eat and have fun with my friends. For me depression made living life so difficult, sometimes virtually impossible. I want to join in and socialise but feel that I just can’t make yourself, or I lose hours of your life just staring into space. I can’t concentrate and work becomes a herculean effort. For me and many others depression also comes with physical symptoms such as headaches, constant muscle aches and exhaustion as well as the unbearable sadness with no apparent cause. My eating disorder almost killed me, and it stripped me of any functioning capability that I had left. Any unhealthy obsession with food or exercise, even if it’s eating healthy or eating ‘clean’, stops you from fully living life. Believe me. My depression and anxiety still affect me, and as much as I am ashamed and sad to admit it I’m not sure I will ever again have a completely normal relationship with food. For me, CBT therapy and particularly medication have worked well but they don’t for everyone. As friends or loved ones of people with any kind of mental illness, it can be so difficult, you want solutions and quick fixes and there aren’t any. I am logical to the max and the irrationality of much of my mental illness has been one of the most difficult things for me to deal with. For anyone who suffers from mental illness, and really anyone who is struggling with stress or sadness for any reason - I hate it when people tell me to be kind to myself, but if you can manage it, then it will hopefully make things easier.” - Anonymous

“My experience with anorexia began at the age of 13; thinking about it now it seems horrifying that I became so preoccupied with something so destructive at an age where body image should have been the last thing on my mind. Looking back, it seems likely that my eating disorder was motivated by a need to feel in control of something after my parents had split up a year earlier, although at the time I didn’t think about it in this way. The problem with anorexia is that in my view of it anyway - you don’t realise what is happening to your body and mind until it is too late. I never set out to become anorexic (and I don’t think anybody really does); after lots of chocolate over the festive period, I had made what I thought was a simple New Year’s resolution to eat more healthily and cut down on the snacks in a bid to shift a bit of post-Christmas weight, despite the fact that I was a completely normal weight and absolutely did not need to lose anything. Even to this day I am a perfectionist and can completely discipline my mind to whatever I decide to do, so unluckily for me in this case it was not long before I found myself in an increasingly downward spiral of healthy snacks, then no snacks, then smaller breakfasts, then no breakfast, then smaller and smaller portions, and so it went on. Obviously by the time summer came around this had had a terrible effect on my body and face that family, friends and teachers could all physically see, but perhaps the worse effect was on my mental health. The best way I can describe the mental experience of anorexia is that it is like having a dictator living inside your head, constantly telling you what to do and shouting down any sense of better judgement. It turned me into a horribly deceptive person, one who would purposely get up before everyone else so I could put cereal crumbs into the bottom of a bowl, leaving the remnants of a breakfast I hadn’t actually eaten in plain sight for when my parents came downstairs. By this point my parents had gotten back together, but even this restoration of order to my life didn’t do anything to help, as I was too caught up in striving for a perfection my mind told me I hadn’t yet reached even as I got skinnier and skinnier. It didn’t matter how many times my mum sobbed and begged, how many times my dad shouted and tried to force feed me, how many times the school nurse called me in to see her; the voice in my head was stronger. At the same time I was also suffering from extreme OCD: there was a certain routine of actions I absolutely had to perform every night in order to ensure that my parents would stay together, that the next day I wouldn’t be forced to eat anything I didn’t want to, that I wouldn’t put any weight on. The whole cycle was absolutely exhausting and I hated it, and coupled with my mental and physical weakness I constantly felt absolutely drained and could never really relax. ... cont.

A couple of months after one of the most unenjoyable Christmases I can remember - one punctuated by arguments and tantrums over food - is when I finally decided that I needed to get better. Unfortunately I had not had a lot of medical support throughout my experience, as my GP clearly had no sensitivity towards the mental side of my condition and let me get down to 4 and a half stone before she even suggested sending me for specialist help. I would say that it was really through the support of my mum and school nurse that I began attempting to change my mindset, and although facing my food fears was difficult and slow it did get easier as time went on. All of this was now around 5 years ago, and although I would definitely term myself recovered, Iâ&#x20AC;&#x2122;m not going to pretend to myself that I am as free and unconcerned about what I eat as I was before I developed an eating disorder, and perhaps I never will be. The difference is that now I know I can ignore the voice telling me not to eat something if I need to, and more importantly I know that how I look can never be worth going back to that mental suffering and the pain it put upon me and my family.â&#x20AC;? - Anonymous

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 familes.

Obsessive Compulsive Disorder Obsessive Compulsive Disorder (OCD) is described as an anxiety disorder. The condition has two main parts: obsessions and compulsions.

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 canâ&#x20AC;&#x2122;t share them with others. The obsessions interrupts 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.

Living with OCD:

Many people experience minor obsessions (e.g. worrying about leaving the gas on, or if the door is locked) and compulsions (e.g. rituals, like avoiding the cracks in the pavement), these donâ&#x20AC;&#x2122;t significantly interfere with their daily lives, or are short-lived. If you experience OCD, your obsessions and compulsions will cause you considerable fear and distress. They will also take up a significant amount of time, and disrupt your ability to carry on with your day-to-day life, including doing daily chores, going to work, or maintaining relationships with friends and family. People often experience shame and loneliness which prevents them from seeking help, especially if the distressing thoughts are about subjects such as sex, violence or religion. - Mind (www.mind.org.uk)

Trigger warning: self harm and suicidal thoughts. “From a young age, I was pushed especially hard and when pen on paper started to matter, I buckled without realising and struggled to appreciate my own success. Inevitably, I was consumed by my perfectionisms and I began to develop anxiety, OCD and depression. At 15 years old, I began self harming routinely because cutting provided an escape from reality. Following an episode, I felt fulfilled because I was proud of being strong enough to cause myself pain and I relished the control I possessed. It was like a comfort blanket and it seemed to make sense of the whirlwind which relentlessly circled my mind and was filled with self-hatred. This was something that was mine and I resented people for forcing me to give it up, even though it was for the best. When I started to think about university, I was hopeful, optimistic and I looked forward to a new start where I wouldn’t be suffocated by criticism. However, I started to think I was incapable and worthless as soon as I became intimidated by other students who looked like they had it all figured out. The numerous social and academic demands caused me to feel extremely overwhelmed and swing from one mood to the next, so after about 8 months of not self-harming, I relapsed. I sometimes feel that there isn’t much point to getting out of bed (as cliché as that sounds) and it’s exhausting to feel like you don’t deserve help or are better off dead. I’ve had Cognitive Behavioural Therapy in the past but I was prescribed antidepressants a few weeks ago and I’m presently using college welfare. To whoever’s reading this, you probably wouldn’t guess that my head is so messed up because at my best, I’m bubbly, driven and a bundle of scouse. I love being that person, and I’m certain I’m beginning to like myself a bit more. I couldn’t be more thankful for the people who have been there for me because without you, I wouldn’t have the strength to get better.” - Lauren Miller

Bipolar Disorder 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 episode (feeling low) - potentially some psychotic symptoms during manic or depressed episodes - mixed episodes (feeling high and low at the same time) Everyone has variations in their mood, but in bipolar disorder these changes can be very distressing and have a big impact on your lie. You may feel that your high and low moods are extreme, and that swings in your mood are overwhelming. You can be diagnosed with different types of bipolar disorder (on a spectrum). In the past, bipolar disorder was referred to as manic depression, so you might still hear people use this term. [means ‘depression with mania’, not ‘severe depression’].

Symptoms of manic episodes

How you might feel - happy, euphoric or a sense of wellbeing - excited, like you can’t get your words out fast enough - irritable and agitated - increased sexual energy - easily distracted, like your thoughts are racing, or you can’t concentrate - confident or adventurous

How you might behave - more active than usual - talking a lot or speaking very quickly - being very friendly - sleeping very little - spending money excessively - losing social inhibitions - taking risks

Psychotic symptoms include Mixed episode symptoms include - delusions, such as paranoia - harder to work out what you’re feeling - hallucinations, such as hearing voices - harder to identify what help you need - exhausting and challenging to manage Depressive episode symptoms are the your emotions same as those previously discussed - more likely to act on suicidal feeling

“I’m actually developing a manic episode as I write this. I’m on the lower end of the bipolar spectrum (or so my psychiatrist thinks, haven’t got a confirmed diagnosis yet), so my episodes don’t always last very long. Maybe an afternoon, a day max. I suffer more from the depression side of things, with a bit of anxiety thrown in there to really spice things up. Right now, my heart rate is increasing. My senses are heightened and I’m very aware of my surroundings. Not in a good way though. Even though it sounds like I’m super on top of everything, I’ve also got a serious detachment from reality - like nothing is actually real. I feel like I’m in Alice in Wonderland, where everything is amazing and new and exciting, with all of the terrifying trippiness and the hallucinations. Unfortunately I get the psychosis along with the mania. My hallucinations are auditory - but not voices, thank goodness. I hear songs. Quite loud. Like when you get a song in your head, but it’s outside your head. Sounds like it’s coming from the other room. When I realise it’s not there, I can make it stop. I don’t always need One Direction to be serenading my life. When I’m having a manic episode it can actually be quite dangerous. I never leave the castle walls unless I’m with someone who knows what’s going on, because the combination of thinking nothing is real and feeling invincible means I could very easily get hurt without meaning to. For example forgetting how to cross the road. I forget how things normally work. If I’m making a cup of tea I need to consciously remember what the steps are, and why I’m doing it. And I need to make sure I don’t burn myself if I get steps mixed up. I’ve been prescribed Diazepam for if my episodes get really bad. It’s basically a tranquilizer, and knocks you out pretty hard. I haven’t taken any yet though. It’s more in case I get a mixed episode, where I get the confusion and detachment from reality alongside the depression. That’s the worst. I know it will get better with time, with the appropriate treatment and selfhelp. I already lessened the amount of mania and psychotic episodes by meditating for 20 minutes everyday. I’ve stopped taking caffeine (apart from in tea), and don’t drink at all (except when I forget I’ve given it up) - which has really helped. It sounds like a scary diagnosis - psychosis sounds like I need to be sectioned - and it can be at times. But I’d always take a scary diagnosis over no diagnosis any day. At least now I know what’s going on my head, and there’s finally a way out, a bit of hope that I’ll recover and live life with some level of ‘normal’, whatever that actually is anymore.” - Kirsten Ash

“Manic depression is a difficult topic, one that comes with many pre- and mis-conceptions, most people will know someone who suffers with depression, and if you want an informative view and summary on depression you can’t go far wrong watching Stephen Fry’s “Secret Life of the Manic Depressive”. This will take the form of a finalists tips for dealing with depression that may help you throughout your university life from someone who’s dealt with it. These won’t work for everybody, they’re simply very personal tips that I’ve found help me get through depressions. For context, I have a form of Depression known as Cyclothymia, but sometimes looks more like Bipolar 2. (Bipolar 1 being the most severe.) These manifest themselves in the form of crushing lows and euphoric highs, either of which can leave people feeling isolated and alone. Don’t be afraid or guilty about unloading to your friends. I have one or two friends at uni who I literally couldn’t have survived without, they’re people who I can come to at any time of the year and say “I feel like crap” or “shit is out of control” and they’ll always give me their time. You can feel guilty about unloading to your friends, it can be a lot to put on their shoulders, but without them you won’t survive. Especially in second year, I remember a period when spent around a week in bed with the lights off, at what might have been the lowest point of my university life, unable to get up and face life, unable to contemplate existing normally, feeling lower than I’d ever felt before, and a certain vss would bring me a cup of tea every morning, wake me up, ask me how I was doing, sit and listen to the response and then get on with his day. I can’t tell you how important those ten minute interactions were to me and how much it helped having someone looking out for you. You could feel guilty about sharing that much with your friends, but when they’re having a bad day, you’ll be there for them. Routine, is key. Though hard to maintain when your moods are swinging, it helps to be regular. Getting up at a certain time, going to bed at a certain time really helps. It won’t “cure” any depression, but it can help you feel more in control when everything starts to spiral. My dad once told me that when I was feeling low I should, every morning, pick a feature about myself in the mirror and say out loud “I like “X” about myself ”. It sounds stupid when put in writing, but it helped me. When depressed, it can augment any insecurities that previously existed, if you don’t like your waistline, when you’re depressed, it becomes the worst thing about yourself, and something you fixate on throughout the day. For me that was my hair, I often don’t like it, but when I’m depressed I fixate on it, thinking it looks stupid, ridiculous etc. But waking up every morning and thinking “at least my eyes aren’t shit” was a small thing that helped. Set up a bank account that you need someone else’s input to access. I’m terrible with money, and even worse when I’m manic. In freshers, during a manic phase I quickly burnt through my overdraft buying guitars and other guitar related...cont.

paraphernalia, only one or two of which I kept subsequently. Since then, I’ve had a bank account controlled by my mother that I transfer any excess cash into if I feel myself becoming manic. This doesn’t always work, as you can’t always catch it, but about a third of the time it’s stopped me spending my life savings on a gold plated Stratocaster with matching top hat. Find a place in Durham that you can call yours, and go there when things get tough. I have a route out of Durham, up towards Newton hall, that’s just countryside, with a little walkway next to the river, that has a tree, at the apex of a meander, with roots that form a sort of seat. It’s incredibly secluded, I’ve only ever seen one or two people go there, and I can sit there, with the hills and Cathedral as a backdrop, listen to Otis Redding’s greatest hits, and just think. If thing’s are especially bad, it’s been a small refuge for me in what can sometimes be a pretty oppressive city. (n.b. Always tell someone when you’re going there, if your friends know you’re low and you disappear for a bit that can lead to Dickie being woken up at midnight to search the Castle for your body. Trust me on that one.)” - Oscar Koronka

Types of Bipolar

Bipolar I

- If you have had at least one high or manic episode, which has lasted for longer than one week - You may only have manic episodes, although most people with bipolar I also have periods of depressesion - Untreated, a manic episode will generally last 3 - 6 months - Depressive episodes last rather longer - 6 - 12 months without treatment

Bipolar II - If you have had more than one episode of severe depression, but only mild manic episodes - these are called ‘hypomania’

Rapid cycling - If you have had more than 4 mood swings in a 12 month period. This affects around 1 in 10 people with bipolar disorder, and can happen with both types I and II.

Cyclothymia -The mood swings are not as severe as those in full bipolar disorder, but can be longer. This can develop into full bipolar disorder. - Royal College of Psychiatrists (www.rcpsych.ac.uk)

Post-Traumatic Stress Disorder 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, asuch 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). Thereâ&#x20AC;&#x2122;s not 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 feelings or memories - Keeping busy, or using alcohol or 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 - Mind (www.mind.org.uk)

Helping Yourself Maintaining your mental wellbeing is just as important as maintaining your hysical wellbeing (and the two are definitely linked!). Whilst it sounds silly, and time consuming, it is really easy to do, and Durham is a great place to do it. 1. Lets get physical You’ve probably heard this a million times before, but exercise not only improves your physical wellbeing, but it improves concentration, sleep and is important in making you feel good about yourself. All those endorphins! 2. Talk about your feelings As I’ve preached for many years, talking helps you think things over, get an important different perspective on things and can significantly improve your emotional wellbeing. Humans are designed to connect with other humans - talk to your friends, welfare, college office or counselling. Most importantly, if your friend comes to talk to you - listen! 3. Eat well You are what you eat! If you eat rubbish, you’re going to feel rubbish. If you eat well, you’re going to feel well. Nutrients and vitamins are important for your body and your brain, and have just as a positive impact on your mental wellbeing as exercise does. (Also apparently a square of dark chocolate a day helps keep depression at bay. Not sure if this is accurate, but it doesn’t hurt to try....) 4. Think before you drink Alcohol is a depressant. The effects that we enjoy - lowered inhibitions, decreased anxiety, feeling happy and carefree - is only temporary, and can actually worsen your mood and wellbeing in the long run. It affects your brain, behaviour and mood, and is a destructive way to manage emotions. 5. Don’t do drugs Goes without saying, but drugs have a similar impact on your emotional and physical wellbeing just as much as alcohol - or more. Some drugs can have an irreversible effect on your brain and mental health.

6. Care for others Sounds counterproductive, but doing something for someone else is one of the best ways to improve your mood. So go and do a good deed for the day, make someone smile, or volunteer for charity. Let those feel-good hormones do their thing! 7. Do something you’re good at Having good self-esteem is important for your mental health. Find something you enjoy, something you can improve in and feel good doing it. Having a sense of purpose and something that makes you happy hs great long-term effects. 8. Meditation and Mindfulness One of the most annoying things when you tell people you have a mental illness is someone saying “have you tried meditation? Or mindfulness?”. But it’s also annoying because they do have a point. Meditation is something you have to practice to feel the full benefits. Doing it every now and then won’t have any effect, you have to keep it up. It isn’t easy, it’s like exercising a muscle, it’s actually possibly to be bad at it at first - we’re not used to thinking in that sort of way in Western societies. After about 10 days you’ll start reaping the benefits. There are many ways you can do this. Colouring books are all the rage nowadays, they help you focus in a calming way. There are books on mindfulness too, they have a whole section in Waterstones. Apps like ‘Headspace’ and ‘Buddhify’ are great for beginners. Taking time out to just be yourself in the present moment helps to decrease stress and greatly improves mental wellbeing. 9. Ecotherapy Getting out and about in nature is a great way to feel good, especially to help combat SAD, whatever the time of year. It is also a form of mindfulness - noticing the little things and engaging with your senses in nature is hugely beneficial. 10. Welfare Walks with Blackjack and Jolene Animal therapy is a long-practised tradition, and combined with the physical exercise, good company and being outside, what’s not to love? 11. Take a break Be kind to yourself, and know your limits. Spending all your time working can make you more stressed out in the long run than taking frequent breaks. Eat well, hydrate, get outside and know there’s more to life than the library!

Helping Family and Friends You yourself may not be experiencing mental health difficulties, maybe it’s a friend or family member. Here are some ideas on how to be supportive:

1. Be there

Sometimes they’ll want to talk, sometimes they won’t. Let them decide if they want to or not, don’t push them either way, but let them know that you’re there if they want you, and let them decide if they want to take you up on your offer.

2. Ask questions

It’s totally okay to say that you’re not sure how to help, and ask them if there’s anything in particular that you could do? Sometimes they could want someone to chill with if they don’t want to be alone, might need someone to go to dinner with with someone that understands the difficulty this could pose, or a roommate to vacate the room for a while to let someone nap.

3. Be open-minded

It’s difficult to ever fully understand without being inside someone’s head. Even if you suffer from the same label, e.g. depression or anxiety, everyone experiences it differently, so don’t suspect to know how someone is feeling. Be non-judgemental, no matter how off the wall someone’s symptoms sound, and listen.

4. Treat them like a person, not a diagnosis

There is more to someone than their illness. It might take up a lot of their time, and they may talk about it a lot, but remember everything else that makes them who they are. People don’t want to be defined by their diagnosis, so if someone confides in you about thir illness, don’t treat them any different than you did before they told you, unless appropriate (see above.)

5. Look after yourself

It’s easier to care for someone if you’re not the only person doing so. Finding someone to talk to the situation about will help your own mental health, for example the welfare team or college office. If you yourself become affected, you’ll be less able to help them!

“Being the parent of a young adult with mental health issues can be a pretty scary thing. You obviously want to do what is right for your son or daughter but knowing what that is can be very difficult, particularly without good expert assistance which can be so hard to obtain. And even when you do know what you should be doing, for example remaining calm, consistent and non-judgmental, it can be so difficult to achieve in the face of irrationality or deception or emotional conflict. And it is not just the dealing with the day to day stuff. There is also coping with the guilt about how this is somehow your fault and the panic that your child might not ever get “better”. And there is the social stigma which still attaches to mental health problems. In her work supporting Children’s Mental Health Week, the Duchess of Cambridge recently urged parents to seek help promptly in relation to mental health issues. This is good advice. My daughter was told that she would not be able to start effective recovery, particularly from an eating disorder, until she fully acknowledged the problem. Sometimes it is parents who need to take this first step. We have to stop worrying about how facing the issue and getting help might reflect on us and our parenting skills or might impact on academic studies and just focus on the only thing that really matters - our child’s wellbeing.” - A parent of a student You can use the anonymous posting system if you need to talk about someone else’s problem that they wish to keep between you. It’s difficult having to keep someone’s secret, especially if you’re not sure what to do about it. You can always ask the welfare team for help or advice whilst not having to mention who it is, or just talk to help your own emotional wellbeing.

Anonymous Posting system http://community.dur.ac.uk/castle.welfare/

Support Services

If you are at risk of harming yourself or others, or would consider yourself as being in a 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)

Hospital

- Go to your local A&E or call 999 in an emergency.

Samaritans

- They offer confidential suport to anyone in a crisis, 24/7. National number - 08457 90 90 90 Durham - 0191 384 2727 Drop-in service (9.30am-9pm) 26 Sutton Street, Durham Email - jo@samaritans.org www.samaritans.org.uk

CALM - Campaign Against Living Miserably

Helpline specifically for men between 15-35 who are in a depressive crisis situation or suicidal National number - 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 www.papyrus-uk.org

You can always ask the Porters for advice - 0191 334 3800

Other (non-emergency) student support services: The Welfare team

- A confidential listening service that can signpost you in the right direction for further help, and provide sexual health supplies as well as earplugs and sleeping masks. - Drop-in sessions every day - Skype: castle.welfare - Welfare phone (9am - 9pm everyday, call or text): 07852 609867 - Email or message any of the team for a 1-on-1 drop in or query - Anonymous Posting System: http://community.dur.ac.uk/castle.welfare/

College Office

College Chaplain, Hannah Cleugh: hannah.cleugh@durham.ac.uk Eva Schumacher-Reid: eva.schumacher-reid@durham.ac.uk Richard (Dickie) Lawrie: r.m.lawrie@durham.ac.uk

Nightline

- A confidential listening service, run by students - 9pm - 7am every term-time night - Phone: 0191 334 6444 - Website: https://www.dur.ac.uk/nightline/ - online chat service - Email: nightline@durham.ac.uk

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. Making an appointment: - Email counsel.service@durham.ac.uk - Phone 0191 334 2200

External Useful Websites

www.mind.org.uk www.time-to-change.org.uk www.rethink.org www.mentalhealth.org.uk www.sane.org.uk ww.ocduk.org www.bipolar.org.uk

A huge thank you to everyone who made this booklet possible. You have contributed a huge amount to the wellbeing and welfare of the JCR of University College, and your bravery at talking about such difficult topics are appreciated by everyone. If anyone has been affected by what we have discussed, do not hesitate to contact the welfare team for more information or advice.