Mental health conditions impair a person’s ability to think, feel and behave in a manner that allows optimum functioning in day to day life, ranging in type and degree from relatively minor to severe illnesses that require ongoing treatment. 1 in 4 people in Britain will experience some sort of mental health problem in the course of a year.
Please note: This is a brief introduction. As such, it does not reflect the full variation in mental health conditions. It is recommended that staff follow the external links provided for more detailed information.
There are a growing number of recognised mental health conditions including (click on the condition for more information):
Depression is not sadness over a matter of days. It is usually a long-term illness, lasting for weeks, months, or years at a time. At its mildest, one may simply feel persistently low in spirit, while at its most severe depression can make one feel suicidal and that life is no longer worth living.
Many people with depression also have symptoms of anxiety and a sense of worthlessness or hopelessness. The two illnesses are often interlinked. Mixed anxiety and depression is the most common mental disorder in Britain, with almost 9% of people meeting criteria for diagnosis. (The Office for National Statistics Psychiatric Morbidity report, 2001)
Impact on Study:
- Loss of motivation: little or no interest in hobbies or sense of ambition
- Easily distracted by negative thoughts/stress
- Difficulty in concentrating on assignments or during examinations, leading for example to failure in meeting deadlines
- In some cases, student may have a subconscious loss of interest in their work as a form of self-harm. It may seem that student has not worked hard enough, or lacks academic interest
Insightful video of depression, characterised by ‘The Black Dog’:
Anxiety is a feeling of unease, such as worry or fear. Those with an anxiety disorder experience more than regular or ‘normal’ anxiety such as that before sitting an exam. It is the main symptom of several conditions, including panic disorder, phobias, post-traumatic stress disorder and social anxiety disorder (social phobia). Generalised Anxiety Disorder (GAD) is a long-term condition that causes one to feel anxious about a wide range of situations and issues, rather than one specific event.
Impact on Study:
- Restlessness and difficulty in concentrating or sleeping.
- In some cases, anxiety feels continuously climactic with no way of lessening. May induce panic attacks.
- Like depression, anxiety induces lack of motivation to work.
- Physical exhaustion, depression.
- Stress may be self-inflicted, but this is not necessarily a conscious decision.
Obsessive compulsive disorder (OCD) is where a person has obsessive thoughts and compulsive activity. An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters a person’s mind, causing feelings of anxiety, disgust or unease. 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.
Impact on Study:
- Students with OCD are often ‘perfectionists’ who may spend more time on trivial matters like the aesthetics of their work rather than the quality. For example, they may worry about selecting the right format in an essay, or the right pictures during presentations, without dedicating enough time to the academic content.
- A student may carry out an action repeatedly as they believe they have not done it sufficiently or just ‘to make sure’ they carried it out in the first place.
- If student does not pursue their obsession or compulsion to a point at which they are satisfied, symptoms of anxiety and depression may ensue.
- A student’s competence to meet deadlines or the quality of their work may be impaired.
Eating disorders are characterised by an abnormal attitude towards food that causes someone to change their eating habits and behaviour. A person with an eating disorder may focus excessively on their weight and shape, leading them to make unhealthy choices about food with damaging results to their health. There a range of conditions that can affect that person physically, psychologically and socially.
The most common eating disorders are:
- anorexia nervosa – when a person tries to keep their weight as low as possible; for example, by starving themselves or exercising excessively
- bulimia – when a person goes through periods of binge eating and is then deliberately sick or uses laxatives (medication to help empty the bowels) to try to control their weight
- binge eating disorder (BED) – when a person feels compelled to overeat large amounts of food in a short space of time.
Impact on Study:
- Physical exhaustion, distraction by negative thoughts, loss of motivation to work.
- Extreme self-consciousness- may increase a student’s level of social anxiety.
- Struggle in examinations, or meeting deadlines for assignments.
- With increased social anxiety, student may for example be unwilling to participate in presentations or confront individuals.
Schizophrenia alters a person’s perception of reality, their emotions and behaviour. Symptoms are categorised as ‘positive/excessive’ or ‘negative/subduing’.
Positive symptoms include:
- Delusions: personal beliefs that are false and based on incorrect inference about external reality; these beliefs are firmly held despite any evidence to the contrary.
- Hallucinations: when a person experiences or perceives things that don’t exist. This may be via any of the senses: a hallucination might be seen, heard, smelt or felt.
- Disturbances in the thought process: these can include a chaotic stream of thoughts or a sudden loss of all thoughts.
Negative symptoms tend to be longer term. They are termed ‘negative’ because they describe a loss of normal functions. They include lack of emotion and motivation, sleep deprivation and fatigue, and becoming withdrawn and isolated.
Impact on Study:
- Hallucinations etc. may distract from work, and impair social interaction.
- Lack of motivation, exhaustion and isolation also contribute.
- Student may struggle with deadlines, or fail to understand the instructions for assignments if thought processes do not remain consistent.
- Student may be very difficult to engage.
Bipolar disorder causes extreme shifts in a person’s moods, with recurring episodes of manic and depressive thoughts throughout their lives, although many are free of symptoms between these episodes.
The symptoms of manic behaviour include:
- An inability to focus or concentrate
- A continuous elevated or euphoric mood
- Inflated self-esteem
- Little need for sleep
The symptoms of depressive behaviour include:
- Change in appetite or body weight
- Self-harm and suicidal thoughts
- Feelings of guilt and worthlessness
- Difficulties in concentrating
Stressful life events or physical injuries as well as other factors can lead to the onset of symptoms of the illness.
A person can have symptoms of both mania and depression at the same time.
Psychotic behaviour may also be present during severe episodes of either mania or depression. This can include delusions and hallucinations.
Impact on Study:
- Behaviour may distract from work, and impair social interaction
- Lack of motivation and exhaustion also contribute
- Student may struggle with deadlines, or fail to understand the instructions for assignments if thought processes do not remain consistent
- Student may be very difficult to engage
Mental health issues can affect study in a number of ways, although without prior knowledge of a diagnosis it may not appear that these effects are caused by a mental health condition.
The detrimental effects of a severe mental illness are more easily identifiable than those of the less severe forms. For example, a student’s studies may be interrupted by spells of relapse, hospitalisation, or experiencing adverse side effects to prescribed medication. Other students may display symptoms that could easily be experienced by any student such as:
- Lacking self-esteem and confidence
- Feelings of anxiety and irritability
- Loss of motivation and inability to concentrate
- Missing lectures, appointments and deadlines
Diagnosable conditions are often not treated and are allowed to gestate. Mental health conditions can also affect a student’s short term memory, reading ability and ability to process new information meaning their condition can be confused with Specific Learning Difficulties. This means that a student that is tired, unwilling to engage and struggling with their studies may not simply be having a bad day.
Studying at university is a stressful time that can exacerbate existing conditions and allow new ones to develop. Undergraduate study is a particularly challenging time as students must juggle the stresses of exams and deadlines, and the pressure to achieve, with the first time experiences of living away from home/abroad, having financial responsibility, and getting accustomed to a new social environment.
Some students will be aware of an existing condition, choosing whether to disclose it or not, and may have created coping mechanisms. Other students, however, will have an undiagnosed condition or will develop one during their studies and may be experiencing mental health problems for the first time.
The symptoms of a mental health condition or the effects of prescribed medication can have adverse effects on study, such as tiredness, anxiety and lack of concentration, creating more stress and making their conditions worse. Furthermore, the stigmatisation of mental health issues and the reactions or undue attention received from fellow students and members of staff can be both stressful and alienating for the student.
If you are concerned for a student direct them to the student Wellbeing Service at Swansea University.
Injuries that are caused deliberately to oneself are considered to be acts of self-harm. The phrase ‘self-harm’ (also referred to as self-injury) describes a wide range of behaviours enacted on oneself, such as:
- drug abuse
- eating disorders
Self-harm is often understood to be a physical response to an emotional pain of some kind, and can be very addictive. It often happens during times of anger, distress, fear, worry, depression or low self-esteem in order to manage or control negative feelings.
Self-harm can also be used as a form of self-punishment for something someone has done, thinks they have done, are told by someone else that they have done, or that they have allowed to be done to themselves.
When helping people who self-harm, it is often more helpful to focus on how someone is feeling rather than what they do to themselves.
Please communicate with the student as you would with any other. Mental health problems (like SpLDs) are not related to intelligence. Ensure you have the same academic expectations of them as their peers.
Acknowledge and speak to a student with a mental health condition as a specific individual in a group situation, otherwise they may feel alienated, and their mental condition may be revealed to people they would prefer did not know.
Avoid labelling a student by discussing the particular symptoms of a condition rather than the condition itself. For example, if a student has trouble making eye contact and as a result appears unfriendly, do not take offence – this may be a coping mechanism or a symptom of a condition.
Listen and have patience with the student by trying to be supportive, whilst sensitive to how they feel.
A student displaying signs of experiencing severe anxiety, irrational thoughts or engaging in irrational or anti-social behaviour should be removed from the situation and further assistance should be sought. Do not try to reason with or challenge the thoughts of a student who is experiencing hallucinations or delusions, tell them you understand that they are experiencing them and try to keep them calm before seeking immediate medical assistance.