Antidepressants; friend or foe?

Antidepressants; friend or foe

 Two (unrelated) students asked me to write this blog. Independently they mentioned at the end of their consultations that there was a lack of positive stories about using antidepressant medication, and that other students might like to hear about some success stories such as theirs. They felt that these ‘good news’ tales might balance some of the very negative opinions that they and their peers were reading online.

Well I have worked at the Students’ Health Service for over 10 years and it has certainly been my experience that the vast majority of students that I treat with antidepressants get better. Treatment times vary, as does the need to try more than one type of pill before finding that one that works for an individual, but alongside psychological therapies, medication is usually successful in helping students return to normality.

Of course we must consider possible side effects (minimised by starting with a half dose for the first week in many cases), and appropriate length of treatment (6 months for a first episode, 2 years or more for recurrences ). It is also vital to withdraw the medication very slowly tailored to an individual’s response. The GPs at SHS are fastidious in planning regular follow up for patients on antidepressants and strive to have continuity of care to allow us to get to know each student as best we can, therefore giving a better overview of treatment response.

Evidence suggests that medication is most appropriate in cases of moderate to severe depression, so we are much less likely to prescribe it for mild cases, and we always encourage other supportive treatments such as increased exercise, counselling and psychological input as necessary.

Six million people are thought to suffer from depression in the UK, and in the last few years the NHS has noted a significant (26%) rise in the prescription of antidepressant medication. Much has been written and theorised on the reasons for this, but it is a phenomenon noted throughout the population, and students are no exception unfortunately. In the face of rising numbers of people with mental health issues it is good to have a treatment that works to offer them, and which shows benefit within usually 4 to 6 weeks. Sometimes people need to take something just to be able to get back to a point of functioning well enough to start talking therapies, of which there is steadily increasing availability on the NHS.

Antidepressants work for the majority of students that we treat, though it needs to be the right one for the individual. They can be life changing, and should always be considered and discussed as an option, though decisions should be made on a case by case basis of course.

I am confident in stating that antidepressants are an important option to be considered in the consultation between the GP and any student who is feeling depressed, and we see significant positive effects on an almost daily basis in our population. It is true that these good news stories don’t excite the media in the same way as negative stories, but that’s no great surprise.

If you are worried about your moods, or feeling low, please do come and talk to us, we really do want to know and help you, in whatever way suits you best.


Dealing with Exam stress part 2

Hi, my name’s Rick and I work at Students’ Health two days a week, delivering cognitive-behavioural based talking therapies to students struggling with difficulties such as anxiety and depression.

 As the dreaded exams loom, the people I see often find that their problems become more difficult to cope with. This is because, frankly, there are various aspects of studying at a University that are psychologically downright unhealthy:

 The perfectionism, the isolated nature of the work, the unrealistic amounts of work expected, the competitive nature of the whole thing, the lack of instant reward for the hours and hours of hard slog put in, the uncertainty about what the future holds beyond University… etc etc etc

 I still vividly remember my own struggles with all this; and anyone who was in the vicinity of the Psychology department at Exeter University in 1989 will maybe recall my own less-than-ideal attempts to cope with it.

 The good news is that 23 years later, I’m full of good ideas about how to deal with the stress of University work, most of which I’ve learned fairly recently from working here with you.

 Here are 5 top tips for psychological wellbeing at this difficult time:


1.   Use a diary/ schedule to plan your work and your revision

     By planning work you can break it down into manageable chunks and hopefully find it less overwhelming. Try not to plan unrealistic amounts; 5-6 hours a day is realistic for most people. Plan breaks and relaxing/ fun activities as well and try to start as early as you can: If you’ve already done 3 hours work by lunchtime, you’re less likely to get stressed as the day wears on.

     Above all, see what works for you.

 2.  Try not to compare yourself with other people

 There are always going to be people who seem to get up at 6.00am and spend their whole day in the library, working for 14 hours without a break. Do not compare yourself with these people and on no account try to compete with them. Work at a pace that suits you, and try not to pick up on other people’s stress.

 3.   Try to avoid falling into spirals of negative thinking

     There are various unhelpful styles of thinking people can fall into when under pressure. These include predicting the future, catastrophising, and  black and white thinking, among others. There’s a link to 12 of these and what to do about them attached below.

 4.   When work stress and anxiety do start to get on top of you, take a look at what you do in response to this

      Do you dive under the duvet? Go to the pub? Switch on daytime TV? Phone a friend? Go for a brisk walk around the block? Surf the internet? Go to the gym? Jump up and down and scream?

      Try writing down what you do, and try to notice what’s helpful and what isn’t, in terms of keeping you calm and allowing you to complete what you need to complete.

 5.   Remember that the whole thing is time-limited: It will not last for ever and you can only do what you can do in the time you’ve got

Soon it will all be over…


If you are struggling with anxiety and/ or depression and would like help and support, you can contact Rightsteps Bristol on 0117 9431111 and self refer. It is a free service. Alternately you can e-mail me at