Thesis getting you down? Read this! Help is here…

It has been said that the letters Ph.D. really stand for Permanent Head Damage rather than Doctor of Philosophy.

Sadly it’s not uncommon for doctoral candidates to experience mental health related difficulties during their studies. Some of this can be down to the nature of the degree. Candidates have to spend a lot of time and energy self-motivating to create new knowledge. Their work is solitary, hyper-focussed and generally not well understood by those around them. They have very intense, unequal relationships with a supervisor who holds a lot of power over them and who may be over or under-involved. By its inherent nature research involves a lot of dead ends, false starts and the ever present spectre of rejection from journal reviewers. And that’s all before undertaking the small task of writing up a book the size of a telephone directory and having to face a viva in front of a panel of experts.

 

As someone who has gone through the doctoral process themselves, supervised several and then ended up working therapeutically with PhD students and academics here is my advice.

 

  • Anxiety, stress and uncertainty are common, but more common as is the dreaded “imposter syndrome” where your typical PhD student wanders around fearful that they will be found out or people will realise that they are not clever enough. It’s all lies. If you are here in the first place, you are good enough.

 

  • Faced with writing a thesis it’s an understandable response to feel one that may be better off dead/ running away/ drinking until oblivion. This isn’t often acknowledged and people suffer, thinking they are the only one that feels like this. If you do feel this way, do seek support because there are a lot of resources at university to help with this. The Students’ Health Service, Student Counselling service, the Student Union and Academic departments can all be possible sources of support when it comes to despair, fear or doubts.

 

  • A good thesis is a finished thesis. It doesn’t have to be perfect, world changing or the last word in your subject area- it just needs to be done. Your PhD is not your magnum opus, it’s really your driver’s licence into the world of research and academia. You may not even be in the same area in the future. I can barely remember what was in mine, and have to think quite hard to even recall the title. However, the research and analytic skills I learned finishing it I still use on a daily basis.

 

  • Get out more. It’s all too easy to spend all of your time in the library/laboratory and feel massive guilt for doing anything other than your thesis. However, balancing your work with friends/ relationships/ healthy eating/ exercise and interacting with the outside world is incredibly important. It also makes you more effective and is probably the best known defence against procrastination, as you have a shorter window of time where you will need to be focussed. It’s only too easy to spend 20 hours a day occupying yourself with not writing.

 

  • You are not your work. It’s only a small part of what you do and doesn’t reflect on your capacity for kindness, altruism, empathy or being a worthwhile human being. It doesn’t even reflect on your intellectual ability as your PhD is more a measure of your tenacity and resilience than it is about how smart you are. Others will love you for a variety of reasons, but your PhD is unlikely to be one of them.

 

  • Best of luck with it. It’s tough. Remember, a thesis is written a line at a time. Keep doing that and it will eventually get done.

SHS Consultant Psychologist Dr Ian Barkataki

A word from our friendly local addiction specialist dr

Hello there, a brief update from my world as an Addiction Psychiatrist.

 

There have been big changes to how NHS services are providing support to people with alcohol and drug problems in Bristol over the last year. We are now providing services as part of ROADS (Recovery Orientated Alcohol and Drugs Service). This is a partnership between organisations in Bristol and aims to provide a seamless service so that when a person contacts ROADS they should not notice that the element of support they need can be provided by one of 5 different organisations. The aim being that all providers focus on the care provided rather than being passed between different organisations.

 

One of the big aims for ROADS was to improving the numbers of people receiving treatment for alcohol problems. Alcohol is the substance that causes the most harm in the UK but it has not had equivalent resources as traditional services focused on illicit drug treatment. There is no distinction between alcohol and drug services now in terms of funding and where people are seen. This is particularly important for young people as many more young people die or come to harm as a result of alcohol problems than for all other substances put together. We have seen a massive increase in the numbers of people referred for alcohol problems, in fact this has been such a success we are struggling to meet the extra demand which has exceeded our expectations.

 

We are still closely monitoring changes in patterns of substance use locally and nationally. An important area is Novel Psychoactive Substances (NPS), sometimes called ‘club drugs’ or ‘legal highs’. Although these substances are often less harmful than alcohol or other more traditional drugs, there are new substances emerging to exploit legal loop-holes which are often more harmful that substances that have just been made illegal. Also we are seeing problems as drugs are not being sold correctly. For example we have several people running into problems, and some deaths nationally, with substances sold as MDMA/ecstasy which in fact contain other more harmful substances such as PMA or PMMA. This is particularly a problem as people take a substance they think is MDMA but think it’s week so take more and then overdose on these more harmful substances.

 

Best wishes for Christmas and the New Year, stay safe, and be respectful of any substances that you put into your body,

 

Dr Tim

Accessing health care over the holidays!

There are a number of ways to access health care in the UK during the vacation:

  1. If you are in or visiting Bristol, you can access care as usual from the Students’ Health Service.
  2. If you want advice about an ongoing issue for which we have seen you, please make a telephone appointment with a GP. Not all medical concerns can be resolved in this way.
  3. THINK AHEAD- if you are running low on a regular medication,  please send repeat prescription  requests by post, with a stamped addressed envelope.  There will be cases when this is not appropriate, e.g. you need up-to-date blood pressure or blood tests.

This useful link gives further advice,

http://www.nhs.uk/chq/pages/1011.aspx

 

  1. If you are away from Bristol and need medical care you can contact a local GP and sign on as a ‘temporary resident’. We advise our students not to sign on as a ‘permanent patient’ if they are returning to Bristol as a student after the vacation, as this causes problems with transfer of medical notes.  Please follow this link for information regarding accessing healthcare in this way

http://www.nhs.uk/chq/Pages/how-can-i-see-a-gp-if-im-away-from-home.aspx?CategoryID=68&SubCategoryID=158

 

  1. Remember that other clinics may meet your needs e.g. local family planning service, STI clinic or minor injury services. Details of these can be found on the link above.

 

  1. Remember that ‘A+E/999 calls’ are for medical emergencies.  If your local GP is closed and you want medical advice for a problem that cannot wait until the surgery re-opens (but is not an emergency), please call 111 to get advice (as you would normally do in Bristol).

Mental Health Awareness Week 12-18 May 2014; Anxiety

As a GP I really like it when a student comes to see me about their anxiety. Not only because it means they are keen to get help and get better, but also because there are so many things we can offer to ease their symptoms. In the last few years, here at Students’ Health Service, we have tried really hard to provide a variety of treatment options for what is the commonest mental health problem that we see; anxiety.

Anxiety affects people differently (about 1 in 20 people will have it at some time), but in general it makes you feel afraid and tense. It can lead to physical symptoms, as your adrenaline rushes around more than usual. People complain of palpitations (fast heart beat), sweating, nausea (feeling sick), chest pains, and shaking. You can also get headaches, and feel out of breath. It can be normal to feel like this, eg before an exam, but when it starts to interfere with everyday life it can become very challenging. Some people get panic attacks, where the symptoms feel overwhelming, and it can feel like the world is closing in on you, or that you might die. Please ask for help if this is happening. Ideally, please see a GP before it gets this bad.

So what can we offer you?

A variety of psychological (talking based) therapies are available. Relaxation techniques and Mindfulness can be learnt, and the Student Counselling Service provides very regular groups. Just sign up on their website.

http://www.bristol.ac.uk/student-counselling/

Self Hypnosis has been shown to be effective, and a GP can refer you for this; a one off free session provided by Matt Edwards in a confidential environment. Here is a blog written by a student who saw Matt last year;

I tried self hypnosis for my anxiety! You could too… a student writes…

 

Online CBT (cognitive behavioural therapy) is available for those who would prefer this method; sign up via the SCS website.

Free NHS groups, and 1 to 1 therapy are accessed via the LIFT Psychology service; no GP referral required, just contact them on

http://lift.awp.nhs.uk/bristolandsglos/

However, if psychological approaches are not enough, or might take too long and your symptoms are too challenging to manage daily, then medication can be extremely helpful, and can work within a few days of starting it. Any of the GPs will be happy to discuss this option with you.

So remember, anxiety is normal and common, but sometimes it can become overwhelming or a daily stress, so get help and talk to us soon!

When you hear the word ‘counselling’ what do you think of?

Two people in a room; one talking and the other just nodding and listening? 
Films have a lot to answer for, and for me that image conveys nothing of the aliveness of the relationship that counselling offers.

For instance, when was the last time that a friend or someone in your family really listened to your experience, without confusing it or comparing it with their own? 

The real trick of counselling is that it creates the circumstances that mean you can fully be yourself. By providing relational sounding boards and mirrors it allows you to see and hear the self you are in this moment. Sometimes someone else can see you changing when you can’t see it yourself.
Most people emerge from experiences of counselling feeling better than they did at the start, more able to function and on a positive trajectory in terms of their mental health, but the chances of this are much increased if they can come along with some openness to the process, some belief it could help in some way. This is one of the reasons we ask people to refer themselves, rather than being required to come: they need just a tiny bit of belief, and it can be just tiny.

The other surprise to some is that counselling is not just about two people in a room, in fact increasingly this is less and less so. The Student Counselling Service now offers about 300 students direct support each week and whilst some of them will be in individual appointments, most of these are either initial assessments to establish the best pattern of care for someone, one off follow ups to these meetings to support a person’s self help, 20 minute initial meetings to establish support choices, or 20 minute ‘Drop ins’ to offer immediate triage and signposting to support, or to help keep them on track with ‘Beating the Blues’ (our online CBT support programme). Even our regular sessions tend to be for fewer than 6 weeks.

Over 100 of the total seen are accessing our regular closed groups or coming just this week to an open group, or attending one of our workshops. And that’s without keeping a count of the number of people who use our resource library and website self help pages.

Because of the range of what we offer we registered over 1600 students last academic year, and so far this year we are experiencing a 20% increase on that. We can’t work with everyone but we have a number of useful contacts in the wider community of Bristol, so that no one needs to feel alone with their concerns.

And just one little plug for group work. If counselling helps you see aspects of yourself you can’t yet see , imagine what it might feel like if other students just like you provided the sounding board, or if someone in the group told a story that made you feel you were not the only one struggling with similar things. It is a powerful moment, and every group sees it, when someone says, ‘it’s such a relief…I thought it was just me’.

http://www.bristol.ac.uk/student-counselling/

 

It’s Time to Talk about Mental Health! #TimetoTalk

This weeks blog is a quiz!

Time to stop the stigma surrounding mental ill health. See how much you know in the attached short quiz, via the link below. Scroll to the bottom of the linked page to see the Myth/ Fact quiz.

Then spread the word. It’s OK to talk about mental health!

http://www.time-to-change.org.uk/downloads

http://www.time-to-change.org.uk/

 

 

 

 

Coughs, Colds and Sore Throats – what you need to know…

Coughs, Colds and Sore Throats are very common particularly at this time of year.

There is no magic cure for the common cold! There is no treatment that will shorten the length of the infection. Treatment aims to ease symptoms whilst your immune system clears the virus. Note: antibiotics do not kill viruses, so are of no use for colds.

For more information and advice about colds please visit http://www.patient.co.uk/health/Common-Cold.htm

Most coughs are caused by viral infections, and usually soon go. There is no ‘quick fix’ for a cough due to a viral infection. You need to be patient until the cough goes, which can be up to 4 weeks.

Most viral coughs clear without complications.

See a doctor if any of the following occur.

  • If symptoms such as fever, chest pains, or headaches become worse or severe.
  • If you develop breathing difficulties such as wheezing or shortness of breath.
  • If you cough up blood. Blood may be bright red but dark or rusty coloured sputum may indicate blood.
  • If you become drowsy or confused.
  • If you develop any symptoms which you are unhappy about, or do not understand.
  • If you have a cough that persists for longer than 3-4 weeks.

For more information and advice about coughs please visit http://www.patient.co.uk/health/Cough-Caused-by-a-Virus.htm

A sore throat usually goes after a few days. Simple treatments that you can buy from a pharmacist can ease symptoms until the sore throat goes. Usually, you would only need to see a doctor if symptoms are severe or if they do not ease within 3-4 days. Have plenty to drink, but avoid alcohol as this can make you more dehydrated, take regular paracetamol or ibuprofen to ease pain, headache and fever and consider lozenges and gargles to soothe a sore throat.

For more information and advice about sore throats please visit http://www.patient.co.uk/health/sore-throat

 

The unwelcome memento…

Welcome to a new academic year at university!

Many of you will have enjoyed Freshers week or simply seeing your friends back in Bristol again..…perhaps there has been a bit more celebration than study? Alcohol can contribute to risk-taking behaviour that could lead to unwanted pregnancies and sexually transmitted infections.

A survey of 16 – 24-year-olds (Define 2008) found that after drinking alcohol

 •            One in seven have had unsafe sex (i.e. Not using a condom)

•             One in five had sex and later wished they hadn’t

•             One in 10 were unable to remember whether they had sex the night before

•             Many (40%) agreed that they would be more likely to have casual sex

How many of you are nodding in agreement..?

Worryingly, Public Health England (PHE) published data in June that showed that new sexually transmitted infection (STI) diagnoses rose 5% in 2012 to almost half a million….HALF A MILLION!!!!

Although in part due to improvements in data collection, the high STI rates in England suggest too many people are still putting themselves at risk through unsafe sex, especially young adults, and men who have sex with men (MSM). Does this include you?

Chlamydia remained the most commonly diagnosed STI (46%), but considerable numbers of genital warts (16%) and genital herpes (7%) cases were also reported last year. New gonorrhoea diagnoses rose 21%. Those aged under 25 experienced the highest STI rates, contributing 64% chlamydia and 54% of genital warts diagnoses in heterosexuals in 2012.

But “I don’t have any symptoms……so I am ok…..right?”

Wrong!

50% of men and 70-80% of women don’t get symptoms at all with Chlamydia infection.

You have up to a 1 in 10 chance of testing positive to Chlamydia!

 That’s why the National Chlamydia Screening Programme exists- its target is to control Chlamydia and its complications, which can include pelvic inflammatory disease (PID), ectopic pregnancy and infertility in women and epididymitis in men.

The advice is that sexually active under 25 year olds should be screened for Chlamydia EVERY year, and on change of sexual partner. Over the age of 25 you should still seek a test following any change in partner.

 

So “how can I reduce my chances of picking up an STI?”  Well, you could just stay home and study, but if that isn’t appealing then consider the following options.

 Recalling that many people with infections are unaware of their status, as they don’t have any symptoms (and therefore cant warn you), the best advice is therefore to  –

  • Reduce the number of sexual partners  you have
  • Avoiding overlapping sexual relationships
  • Always use a condom when having sex with casual and new partners
  • Get tested regularly if you’re in one of the higher risk groups (eg MSM)
  • Get screened for chlamydia every year (if aged under 25) and on change of sexual partner.

 

You can access testing through the Students’ Health Service- see the contraception and sexual health section on our website for more details. You can also pick up a self-testing kit for Chlamydia (and it also tests for Gonorrhoea too) in the practice- they are on the windowsills along the corridors and in the waiting room.

So make sure it’s a memorable start to the new academic year…for all the right reasons and that your not left with an unwelcome memento of that big night out!

Watch out for your mates…. Tales of Meningitis

 

“I was revising in the library for my last exam, getting excited to go home for the summer when I felt a rush of shiver run through me. I got a headache, felt sick and cold.  My headachegot worse as the day went on and I was so tired.  My friend lent me his jacket and I fell asleep with my head on the desk for a while”

And about another university student-

“The next day she said she still felt under the weather, was going to bed early. We owe her life to her housemate, Andy, who noticed she hadn’t got up the next morning.”

Both of these students had meningitis and survived due to their friends seeking medical help and calling 999 when they were found seriously unwell.

Meningitis is thankfully rare, and rates of one type- Meningitis C – are reducing, due to vaccination with the Meningitis C vaccine. But we cannot vaccinate against all types yet.

Meningitis can affect all age groups, but young adults are at higher risk. This is especially the case for students living in halls and socialising in larger groups.

So what is Meningitis?

It’s inflammation of the membranes surrounding the brain and spinal cord- the meninges. Septicaemia is the blood poisoning form of infection.

Viral meningitis is the most common form, and is usually less serious than bacterial meningitis. There are around 2,500 cases of bacterial meningitis yearly in the UK, and double that number of viral cases.

 In the UK the most common form of bacterial meningitis is meningococcal and pneumococcal meningitis. Meningococcal meningitis and septicaemia often occur together. 10% of bacterial meningitis cases result in death and 15% will result in long term complications.

So what do you need to watch for?

General symptoms

These symptoms can develop as part of the body’s normal response to an infection.

  • Vomiting and/or diarrhoea
  • Severe lethargy (tiredness, exhaustion, fatigue)
  • Irritability/Unsettled behaviour
  • Ill appearance
  • Severe joint/muscle pain
  • Headache
  • Breathing difficulties
  • Fever

Specific symptoms of MENINGITIS

These are more specific to meningitis and are less common in other illnesses.

  • Stiff neck 
  • Dislike of bright light 
  • Seizure, stiff/jerky movements
  • Altered mental state/confusion 

Specific symptoms of SEPTICAEMIA

These symptoms are more specific to septicaemia. However, other illnesses may also cause some of these symptoms, such as the non-fading rash.

  • Cold hands & feet 
  • Leg pain 
  • Abnormal skin colour 
  • Altered mental state/confusion
  • Non-fading rash 

So what to do?

Make sure you have had your Meningitis C immunisation (and check for 2 MMR injections too whilst you’re at it!)

Be aware of the symptoms and signs of meningitis and septicaemia, and act on any concerns- seek help!….and watch out for your mates!

 

http://www.meningitisuk.org/

http://www.nhs.uk/conditions/Meningitis/Pages/Introduction.aspx

Download the free app- Meningitis signs and symptoms by the Meningitis Trust

BBQ safety!

Plan ahead for barbecue weather!

The summer break has arrived for most students, and while the weather might not be as sunny and warm as we’d all hoped, there has been the odd day of great weather.

Barbecues are one of the most popular social activities over the summer but before you dust off your old barbecue and start heating up the coals, here is some essential fire and barbecue safety advice from fire safety specialists Firemart (www.firemart.co.uk).

Take care when deciding where to position your barbecue
Barbecues should only be used on flat surfaces, outdoors, and you should ensure they are not placed near any shrubs, trees or any furniture which could catch fire.

It’s also worth thinking about your use of the outdoor area – any games or activities taking place should be kept well away from the barbecue area, as well as away from any children or pets.

Safe Barbecue usage
If you’re in charge of cooking on the barbecue we advise that you avoid drinking alcohol until your cooking duties have finished.

For coal barbecues, only use approved barbecue lighter fluid, and make sure you use the minimum amount necessary. You should never use petrol or other fuels which were not meant for barbecues as these can ignite ferociously…and there could be the added side effect of your food tasting strange!
Choose barbecue utensils like tongs and forks which have long handles.

Food preparation

Aside from the fire safety elements, there are also some considerations when it comes to preparing your food for the barbecue. If you’re cooking meat from the freezer, ensure it is properly thawed before you cook it.

Remember that raw meat needs to be kept separately from cooked food – use different containers and utensils for each.

To avoid upset tummies the next day, ensure your meat is cooked on the barbecue throughout by turning it regularly.

After your Barbecue

Wait until your barbecue has cooled down completely before you attempt to move it or clean it, and never place hot barbecue coals into your bin. If your barbecue has a lid, you can speed up the cooling down process by placing the lid on – this removes the oxygen.

Some final tips
If the sun is out, don’t forget to wear sun screen, and if you’re feeling too hot then spend some time in the shade. Keep yourself hydrated throughout the day by drinking plenty of water.

 

If you keep the above guidance in mind, and plan in advance for the next day of good weather, your next barbecue should be a success!