Underwood Surgery

139 St. George's Road, Cheltenham GL50 3EQ

Mental Health

Mental Health Advice for University Students

The following information and links may provide some support and practical advice. Click any of the bookmark links below to skip down the page to the correct section.


The word "anxiety" is used to describe the mental and physical response to feared and threatening situations. This reaction may include blushing, trembling, a feeling of choking, increased heart rate, and sweating. Anxiety is a normal response experienced by everyone at times. A certain amount of anxiety is required in everyday life to motivate us. Sitting an exam or giving a public talk are examples of situations in which most people would experience some anxiety. However, if our anxiety goes on for too long or occurs too frequently, it can become a problem. Anxiety can be disabling in that it can stop us doing things because we are so fearful of them.

You are likely to be suffering from an anxiety disorder if you have any of the following:

  • The anxiety reaction occurs frequently
  • Your fears are out of proportion to the situation
  • You start to avoid places or situations where you experience anxiety
  • It interferes with your working, social or family life

There are various ways to assist in overcoming your anxiety, which include:

  • Books On Prescription.
  • Cognitive Behaviour Therapy (CBT) which addresses links between feelings, behaviour and actions.
  • Talking Therapies such as the University Counselling Service
  • Antidepressants should your GP feel that this is the correct choice of treatment.


Stress is the wear and tear our bodies experience as we adjust to our continually changing environment; it has physical and emotional effects on us and can create positive or negative feelings. As a positive influence, stress can help compel us to action; it can result in a new awareness and an exciting new perspective. As a negative influence, it can result in feelings of distrust, rejection, anger, and depression, which in turn can lead to health problems such as headaches, insomnia, ulcers, high blood pressure, heart disease, and stroke. We all experience stress in adjusting to differing circumstances in our lives; stress will help or hinder us depending on how we react to it.

We can thrive under positive stress such as deadlines, competitions etc, as it adds anticipation and excitement to life. Insufficient stress acts as a depressant and may leave us feeling bored. But excessive stress is not helpful and can lead to problems. An optimal level of stress can motivate but not overwhelm us. It is important to learn how to manage it and how to use it to help us.

There are various relaxation techniques that can be learnt to assist our levels of stress such as breathing techniques, autogenic relaxation, guided imagery, tensing and relaxing muscle groups etc. Hobbies such as yoga, tai chi are also helpful.

Other helpful resources include:

  • Books On Prescription.
  • Cognitive Behaviour Therapy (CBT) which addresses links between feelings, behaviour and actions.
  • Talking Therapies such as accessing the University Counselling Service
  • Your GP may choose to prescribe some Antidepressants should they feel this is the correct treatment choice.

Exam Stress Tips

  1. Recognise the symptoms - temporary effects of stress include lack of concentration, inability to sleep, difficulty in processing information and irritability. Prolonged or high levels can lead to mental health problems such as depression or anxiety.
  2. Make time to do things you enjoy - hobbies and physical exercise that help release those restrained endorphins!
  3. Pay attention to your thoughts and feelings. It's a false belief that stress is necessary to perform so don't rely on it!
  4. Prioritise a list of activities that you value and do something each week
  5. Assess demands; is time management an issue, can you plan this better. Do you need to look at study skills / social skills / self esteem issues?
  6. Challenges and struggles are part of life. Be realistic about what is achievable. Create a flexible routine with time for commitments, study, & relaxation
  7. Take care of friends and demonstrate that you care for them
  8. If you're not performing / unable to attend lectures or be with friends - something is probably wrong, it is important to seek help at this point.
  9. BEFORE exams - think positively, concentrate on your strengths and think about successful outcomes in the past
  10. AFTER exams - walk out and move on, don't worry about how it's gone. Once its gone it's gone and time to focus on the next chapter.


Many people use the word depression to describe feelings of sadness and loss. These feelings often pass within a few hours or a few days. During this time people are able to carry on much as usual. The illness, which your doctor calls depression, is different from this. You feel sad much more intensely and for longer. It is common to lose interest in things that you used to enjoy. Depression commonly interferes with your work, social and family life.

Depression can also affect people in many other ways. Common symptoms are:

  • Disturbed sleep
  • Changes to appetite
  • Physical aches and pain
  • Lack of energy or motivation
  • Irritability and intolerance
  • Feelings of guilt
  • Loss of concentration

There are various ways to assist in overcoming your anxiety, which include:

  • Books On Prescription.
  • Cognitive Behaviour Therapy (CBT) which addresses links between feelings, behaviour and actions.
  • Talking Therapies such as accessing the University Counselling Service
  • Antidepressants should your GP feel that this is the correct choice of treatment.
  • Your GP may choose to prescribe medication such as antidepressants should they feel that this is the correct choice of treatment.

Books on Prescription

This is a local joint initiative between the local libraries and the and Mental Health Services, who have arranged for a number of books to be available on topics such as anger, anorexia, anxiety, bulimia, depression, obsessions and compulsions, panic, PTSD, self esteem and stress.

The list of current recommended books can be found on the Let's Talk webpage on the trust website: www.talk2gether.nhs.uk/

Self Harm

Self-harm is when someone deliberately hurts or injures themselves and can include:

  • cutting
  • taking overdoses of tablets or medicines
  • punching themselves
  • pulling out hair or eyelashes
  • scratching, picking or tearing at one's skin causing sores and scarring
  • burning
  • inhaling or sniffing harmful substances

Some people self-harm regularly while others do it occasionally. For some people it is a coping mechanism and they stop once the problem is resolved. Other people continue to self-harm whenever certain kinds of pressures or feelings arise. A few people who self-harm may go on to commit suicide - generally this is not what they intend to do. In fact, self-harm can be seen as the "opposite" as it is often a way of coping with life rather than of giving up on it. Self-harm can vary in intensity from, for example, superficial scratches to deep lacerations that can involve serious injury to bodily parts that require immediate medical attention in hospital. There may be many underlying reasons for someone to self-harm, but it is usually seen that talking therapies are supportive methods to help overcome such a problem. This may include:

  • Books On Prescription.
  • Cognitive Behaviour Therapy (CBT) which addresses links between feelings, behaviour and actions.
  • Talking Therapies such as accessing the University Counselling Service

Suicidal Thoughts

Depression, anxiety, stress, academic pressures, burn out, feelings of being homesick, financial pressures, conflict, relationship problems can all lead to feelings of despair and suicidal feelings. If you are having thoughts of suicide then telling someone is the first step to feeling better. You may not care if you live or die at the moment but you can think and feel differently with help.

It is important that you talk to someone about how you are feeling. Sometimes speaking to a trusted friend or family member can relieve some of the stress and despair.

It is also important to see your GP or the Mental Health and Well-being Advisor for the Medical Centre. Both can provide help, support and can discuss medication options with you if this is appropriate. It can feel scary seeing a professional about this but don't forget that 50% of GP consultations are about mental health issues and 13% are about suicide or self-harm. Medication may help to reduce your feelings of despair and many people take anti-depressants or anti-anxiety medication to help lift their mood.

There are many support services that can help such as The Samaritans or the University Counselling Service


If you have arrived at University with a known eating disorder, please inform us for the Medical Centre. We will then be able to discuss the most appropriate course of action for your needs, which may include a referral to the local Eating Disorder Service. It may be that an eating related problem has come to light since you have been here, in which case please do not suffer alone, it is important to seek help.

With eating disorders there is usually a presence of:

  • disturbed perception of body image
  • a pre-occupation with food
  • slimming or dietary books
  • an increase in exercising
  • use of laxatives
  • binge eating

Are you or have you begun to weigh yourself on a regular basis?

Do you make yourself sick because you feel full?

Do you worry that you have lost control over how much you eat?

Have you recently lost more than one stone in a 3-month period?

Do you believe yourself to be fat when others say you are thin?

Would you say food dominates your life?

There are numerous reasons why any of the above may begin to happen and can sometimes be linked to lifestyle changes, relationship problems, homesick, undue stress and pressure. There is help available whether that is through talking therapies or the University Counselling Service.

Alcohol Problems

Whilst it is part of University culture to socialise, some students may become involved with heavier use of addictive substances than they would normally anticipate or like to do and problems can occur. This can have a knock on effect with friends, neighbours, finances and study.

Although alcohol in moderation can have its benefits, in the realms of socialising, making friends and enjoying oneself, it is actually a depressant and can also have many negative effects. Too much alcohol on a regular basis can affect all areas of our body. The recommended daily intake of alcohol is much lower than many people imagine and is as follows:

Males - 3 to 4 units per day with drink free days in the week Females - 2 to 3 units per day with drink free days in the week.

To calculate the number of units you are drinking please visit:


If you think you are drinking in excess of this, it is recommended that you complete a drink diary for one week to see exactly how much you are drinking. If it exceeds the recommended levels it is worth seeking help to discuss how you may be able to reduce this amount.


A contentious issue, however, the University has strict guidelines and policies regarding misuse of drugs, it is known that some students experiment with recreational drug use and some may even have issues of dependence. Fortunately most students are aware of the addictive nature of drugs. However for any student with a problem, it is very different. They may be reluctant to seek help in case it affects their ability for them to continue at University. This is not necessarily the case and help is available. Confusion can also arise over the classification of drugs and in recent times, especially in relation to the reclassification of cannabis.

The following can provide more detailed information. If you remain concerned regarding your own drug use or even that of another person please do not be afraid to seek help.

Students should also be aware of the risks of drinks being spiked with illicit drugs when you are out in pubs and clubs. Spikeys are available from the Sabbatical Officers and SU Offices.

Recognised Mental Health Problems

If you have arrived at University with a known Mental Health problem and are on related medication, it is important that you make an appointment to see one of the doctors for the Medical Centre. This ensures that we, for the Medical Centre are aware of your current problem, the level of care you have currently been receiving, and by doing so, we can ensure that you receive appropriate ongoing treatment. We can liaise with your home Mental Health Services and if required make appropriate referral to our local Mental Health Services. If you are prescribed medication for a Mental Health problem, it is important we are aware of this information should you require a repeat prescription in the future.

It may also be pertinent to inform the Disability Services at the University of your Mental Health problems. They also offer a confidential service and can be contacted via:

There may be support services available to assist you with your studies, which can include financial support, assistance with taking notes in lectures or IT equipment. Please contact General Welfare via:

There are many other support services available locally and a wealth of information on the web, many of these can be found listed below in Other Areas of Support.

Relationship problems including bereavement, or physical trauma.

Many students coming to University can suffer from relationship problems at some time, whether this is the relationship changes that happen when you move away from family and friends, or the making, building and sustaining friendships and relationships whilst at University. Some students may find that their relationship with family changes more than they had anticipated and it feels strange to go back home. Close friends who were at home may have also moved on to other things and that can leave feelings of isolation. For some it may be something new to build friendships or to experience relationships and these will naturally have their ups and downs. For most, this involves a period of stress which is overcome in time, but for some this can develop into an issue which requires help and support.

Some students will experience their first bereavement whilst away from home and this can be a difficult and stressful time, trying to be supportive to relatives and yet trying to hold things together at University.

Some students may come to University with issues surrounding previous physical and / or trauma. It may be difficult to find someone new to trust and confide in. Alternatively there is always the problem of experiencing recent physical and/or traumas.

Any of the above can impact of your mental health and it is important to seek support to assist you through this whilst being able to maintain a focus on your studies.

Talking Therapies such as accessing the University Counselling Service can also be most helpful.

I Am Concerned About My Friend / Flat mate - What Should I Be Doing?

Firstly, it is good to talk and use your skills as a friend to offer support or to find out if there is anything you can do to help in a difficult situation. It may be that your friend is overwhelmed with the usual worries of being a student (finances / amount of academic work / missing family etc) and a good reliable friend is often invaluable in these circumstances.

However, the problem may seem much more difficult than this. For example if your friend is not attending lectures, not socialising or not behaving in their normal manner. It may be appropriate to tell your friend of your concerns in a tactful manner, and be there to offer support. It may be possible to explore ways that those sharing accommodation together can support each other. Alternatively if the situation seems too much for you to realistically offer your individual support then you can express your concerns to a third party such as your Accommodation Warden or Student Services. They may be able to provide advice and support to both you and your friend. It may be that you feel you need to access support also, this is normal and there are many avenues where you can go whether it is the Student Services, Medical Centre or the University Counselling Service. All will offer support in a confidential manner.

Unfortunately there are some that deny there is a problem with their behaviour and who refuse any support. It is important to recognise that this is OK and accept that as a friend, you will have done as much as you could in the given situation and that you have referred the problem on to a University or Health professional.

Concerns Regarding Medication

If you have arrived at University with a prescription from your previous home GP, please make an appointment to see one of the GP's for the Medical Centre so we are aware of the medication, and can ensure that you are receiving appropriate ongoing care. It is also important that we know this information should you need a repeat prescription in the future.

If you are having any concerns regarding any medication prescribed by the Medical Centre GP's, experiencing side effects for example, please make an appointment for this to be reviewed. If you are unsure of any medication that your GP, or our local Mental Health Services have prescribed (specifically in relation to Mental Health problems), then it is preferable that you seek their advice in the first instance. They would be best placed to know your full details and advise accordingly.

If you are linked in with the local Mental Health Services, then the Mental Health and Well being Advisor can work with you and the Mental Health Team members to complement your care and ensure you receive ongoing appropriate support.

What is 'good' mental health?

It's not just the absence of mental health problems. Individuals with good mental health:

  • Develop, creatively, intellectually and spiritually
  • Initiate, develop and sustain mutually satisfying personal relationships
  • Face problems, resolve them and learn from them
  • Are confident and assertive
  • Are aware of others and empathise with them
  • Use and enjoy solitude
  • Play and have fun
  • Laugh at both themselves and the world

How can we help ourselves?

  • Make time to do the things we enjoy
  • Take moderate physical exercise
  • Cut down on coffee, alcohol, nicotine and other addictive substances
  • Remember to celebrate the things we like about ourselves
  • Keep things in perspective
  • Develop and sustain friendships
  • Listen to and respect others, even if we may disagree with them
  • Ask for help if we feel distressed or upset
  • Listen to other people who say they feel distressed or upset
  • Take as much care of ourselves as we do the people we care about

This page was last updated in March 2018