## 3.1 What you will learn

By the end of this chapter you will be able to:

• Identify some of the symptoms of mental ill health in yourself and your peers, particularly anxiety and depression
• Describe five self-help techniques for improving mental health
• Describe services and other people you can approach if you (or someone you know) is being affected by mental ill health and self-help isn’t enough
• Schedule activities for improving mental and physical health into your daily or weekly routine

⚠️ Coding Caution ⚠️

I am neither a medical doctor or a psychologist: If you’re affected by mental ill health, you should speak to a trained professional. This chapter just gives you a quick overview of mental health and points you to where you can find out more.

## 3.2 Mental ill health

Stress can lead to many kinds of ill health. Turing was put under lots of stress by his government bosses, people like Alastair Denniston and Stewart Menzies. When asked why he punished himself so much in training, Alan Turing’s reply is shown in figure 3.2.

University is a positive experience for many people, however like Alan, you may also experience periods of stress. This may also be accompanied by anxiety, loneliness and depression. Financial, social and academic pressures alongside concerns about employability and an ongoing pandemic of COVID-19 can all have an impact on your wellbeing. Statistically, one in four of us will be affected by mental ill health during our lifetime. Two of the most common forms of mental ill health are:

• Anxiety: persistent feelings of unease, such as worry or fear
• Depression: a low mood that lasts for a long time and affects your everyday life

The persistent and lasting a long time are important here because while its part of the human condition to worry and feel low, that doesn’t necessarily mean you are affected by poor mental health.

### 3.2.1 Anxiety

Anxiety is one of most common mental health disorders and can lead to depression, increased risk of suicide. Generalised Anxiety Disorder (GAD), a common form of anxiety is explained in the video in Figure 3.3 and at nhs.uk/conditions/generalised-anxiety-disorder. People who are affected by anxiety may struggle to function normally, and find routine everyday task difficult or impossible.

### 3.2.2 Depression

Millions of people around the world live with depression. If you are affected by depression it can be really hard to talk about it as there are many social stigmas around mental health. Thankfully depression is largely preventable and treatable. Recognising depression and seeking help is the first and most critical step towards recovery. To mark World Mental Health Day writer and illustrator Matthew Johnstone tells the story of how he overcame the “black dog of depression” in the video in Figure 3.4 made in collaboration with the World Health Organization (WHO).

### 3.2.3 Drugs

Prescription medication can help some people with their mental health. For example, when I was affected by depression, Selective Serotonin Reuptake Inhibitors (SSRIs) worked for me, shown in Figure 3.5, but they don’t for everybody. Sometimes the drugs don’t work, they just make you worse.

Some doctors prescribe benzodiazepines for anxiety, which may be effective where SSRI’s are not, but these can be addictive and have big side effects.

It is often worth considering cognitive behavioural therapy (CBT) before taking any medication. The Science of Wellbeing (TSOWB) at coursera.org/learn/the-science-of-well-being is an easy way to access some CBT free online. See the signposts section at the end of this chapter

## 3.3 Look after yourself

Looking after yourself can serve to both prevent and treat mental health issues that can affect you in life. You might be your own worst critic, or perhaps when you’re under pressure you neglect things that are proven to be beneficial for your mental health, like sleep, exercise, mindfulness and friendship. Looking after yourself means at least three things:

• being mindful of your feelings and learning to manage your inner critic
• being kind to yourself in various ways
• deliberately scheduling protected time to do the non-work things that matter.

Harvard Psychologist Laurie Santos describes five evidence-based strategies for coping when times are really challenging and tough in the video in figure 3.7. Those strategies are:

1. Exercise: getting regular exercise improves both physical AND mental health.
2. Gratitude: research shows that being grateful can significantly improve your mental health. One way to do this is by keeping a gratitude journal, a log you fill in everyday of things you are grateful for (either small or big)
3. Sleep: actively developing healthier sleep patterns. Poor sleep hygiene can be both cause and effect of poor mental health. See the discussion of Why we sleep in section 3.6
4. Socialising: prioritise time with friends and family, rather than turning inward or diving deeper into work
5. Mindfulness: be mindful of emotions using the R.A.I.N. technique:
• Recognise: negative emotions
• Accept: accept emotions rather than fighting them
• Investigate: notice how the emotion feels inside your body
• Nurture: be kind to yourself, step away from your emotions by distancing yourself from them.

It can help to think of negative emotions as coming from another person, an inner critic, rather than yourself. You are not your emotions and thoughts. Laurie explains the R.A.I.N. technique in figure 3.7.

So there are things you can do to help yourself, but you may also need to seek help from others.

Sometimes a desire to be productive by working hard has the opposite effect, because the sacrifices you make can be counter-productive.

## 3.4 Help is available if you need it

If you are affected by mental ill health, particularly anxiety or depression, it can be hard:

• to recognise that you need help in the first place

Even if you don’t need help, it is important to recognise and understand the symptoms of mental ill health. It’s quite likely that someone you know will suffer from mental health issues and as their friend or peer, it might be you that can help by encouraging them to get the help they wouldn’t otherwise ask for.

You are not alone, help is available if you (or your friends) need it from a wide variety of sources:

• non-academic staff in the University, for example in Manchester contact the Student Support Office (SSO) studentsupport.manchester.ac.uk
• counselling services, for example contact counsellingservice.manchester.ac.uk. The counselling service offers help on dealing with anxiety, depression, exam stress, confidence and other issues.
• peers, flat-mates, family, friends etc. People close to you can help, although some people affected by mental health find it easier to discuss mental health with a trained professional or volunteer because of the social stigmas. There are lots of services outlined below that provide this kind of service.

### 3.4.2 The National Health Service

As a student studying in the UK you are entitled to access free healthcare provided by the National Health Service (NHS) of the United Kingdom. To do so you’ll need to be registered with your general practitioner (GP), see nhs.uk: Getting medical care as a student

Your doctor can advise you on medical treatment if required, see for example nhs.uk/conditions/antidepressants

### 3.4.3 Nightline

Nightline nightline.ac.uk is a confidential listening and information service run by students for students. Nightline is open 8pm till 8am every night during term time. It offers anonymous, non-judgmental and non-advisory support for students as described in figure 3.8.

Manchester students can contact nightline at nightmail@nightline.manchester.ac.uk and expect a reply within 48 hours. See manchester.nightline.ac.uk for details.

### 3.4.4 The Samaritans

The Samaritans are a charity who provide emotional support to anyone in the the United Kingdom and Ireland that:

• is suffering from emotional distress
• is struggling to cope
• is at risk of suicide

The name of the charity comes from the Parable of the Good Samaritan although the organisation itself is not religious. The Samaritans are available 24 hours a day, seven days a week, to talk confidentially about any problem, however big or small. See samaritans.org or telephone 116 123.

### 3.4.5 Students Against Depression

Students Against Depression (SAD) acknowledge the devastating impact that depression can have on those experiencing it, as well as on their friends, family and supporters. For further help in understanding and coping with suicidal thoughts, and emergency contacts in a crisis, visit studentsagainstdepression.org

Actor Ruby Wax has written about mental health and how the “internal critics” in our minds can send us mad in her book Sane New World. She is interviewed by Students Against Depression in the video in figure 3.9 about using mindfulness to “dodge the bullets” of depression.

### 3.4.6 Papryus

Suicide is the biggest killer of under 35’s in the UK. Papyrus believe that many young suicides can be prevented, they are a national charity that you can find out more about at papyrus-uk.org or telephone the free number 0800 068 4141.

### 3.4.7 Self-help services

Self-Help services are a mental health charity which helps people to help themselves, see selfhelpservices.org.uk or phone 0161 226 3871.

### 3.4.8 MIND

MIND provide advice and support to empower anyone experiencing a mental health problem. They campaign to improve services, raise awareness and promote understanding of mental health issues. Find out more at mind.org.uk and in the video in figure 3.10

### 3.4.9 Student minds

Student Minds empowers students to look after their own mental health, support others and create change, find out more at studentminds.org.uk and in the video in Figure 3.11 which describes why it is important to talk about student mental health.

### 3.4.10 Togetherall

Togetherall is an online community for people who are stressed, anxious or feeling low. The service has an active forum with round-the-clock support from trained professionals. You can talk anonymously to other members and take part in group or 1-to-1 therapy with therapists. Togetherall is for anyone aged 16 or over who wants to improve their mental health. The service is free for many universities. Find out more at togetherall.com and in the video in figure 3.12 which describes why its important to talk about student mental health.

## 3.5 Developing a growth mindset

Learning at University can be hard because you might have gone from being at (or near) the top of the class in high school to no longer being top of the class at University.

Likewise the job hunting described in chapter 8 can take a heavy toll on your mental health because repeated rejection is an ordinary part of the process. It can be time consuming, stressful and demoralising. You may find your applications disappear into a black hole. They will be ghosted (ignored) by employers. Interviewers will blank you and refuse to give you meaningful feedback because they’re too busy. This could happen multiple times. This is all par for the course, normal and expected, and is not necessarily a reflection on your abilities or potential. See the examples in the coding interview section 10.2.3.

Adopting a growth mindset can be a successful strategy for maintaining your wellbeing, see figure 3.13. If your grades aren’t has good as you hoped or your search for employment is being met with repeated rejection, a growth mindset can help. Let’s take rejection from potential employers as an example, there are two ways you can react to it:

1. Fixed mindset: responding with a fixed mindset will mean you are likely to take rejection personally. You might even assume that this confirms what you’ve always suspected. You’re not good enough or that you made some fatal mistake in your applications or interviews. Ouch.
2. Growth mindset: by responding to rejection with a growth mindset, you focus on what happens next. Rejection is not failure but a “not yet” described in figure 3.14. Maybe you’re not yet ready for that employer, but you’ll definitely have a good idea of what you learned from the process and how can you do better next time.

According to Stanford psychologist Carol Dweck we can all be placed on a spectrum describing where we think our abilities come from. At one end, the fixed mindset assumes all kinds of abilities are fixed traits while at the other end, a growth mindset assumes these abilities can be developed over time. There is good evidence that adopting a growth mindset will make you a better learner who can cope with the inevitable failures and rejections in life better. This approach can be used in a range of different disciplines such as learning programming languages , music and job hunting.

## 3.6 Wellbeing signposts

This chapter has looked at your wellbeing and especially the role that both your mental health and physical health play in your future. Matt Haig’s first-hand accounts of poor mental health will be comforting to anyone who is affected by mental ill health. Even if you’re not affected, there is a 25% chance you will be at some point in your life. There’s also a high probability someone close to you will suffer from mental health issues. It might be a colleague, friend, family member, fellow student or partner, so it is worth educating yourself on the issues by reading his two short books:

1. Notes on a Nervous Planet is a personal account of anxiety
2. Reasons to Stay Alive is a personal account of depression

What’s good about Matt Haig’s books is they are quick and easy to read, but give plenty of first-hand insight into what mental ill-health can do to people (including you). Matt describes his top five tips for good mental health in figure 3.15

There’s plenty of evidence that social media can have a detrimental effect on health. Jaron Lanier’s skeptical polemic Ten Arguments for Deleting Your Social Media Accounts Right Now is a thought-provoking romp through some of the pitfalls of social media that may have you reaching for the delete or un-install button fairly quickly. You don’t have to be on social media, see figure 3.16.

If all these books are making you sleepy, neuroscientist Matthew Walker’s Why We Sleep: The New Science of Sleep and Dreams may change your view on the importance of a good nights sleep.

Finally, it’s well worth taking a look at Laurie Santos course on The Science of Wellbeing (TSOWB) at coursera.org/learn/the-science-of-well-being. TSOWB course provides an alternative to medication as it follows the principles of cognitive behavioural therapy (CBT).

TSOWB is the most popular course at Yale University and looks at some simple techniques you can use to improve your happiness. The course will help you increase your happiness and build more productive habits. Using the latest research, Santos describes the misconceptions about happiness and “annoying features” of your mind that can impair your well-being. The course takes about 19 hours to complete but you can spread this over a whole semester (or longer) if you choose. The short clip in figure 3.7 gives you a brief taster of Laurie’s style and work.

## 3.7 Breakpoints

Let’s pause here. Insert a breakpoint in your code and slowly step through it so we can examine the current values of your variables and parameters.

* PAUSE ⏸️
• How would you describe your own state of mental health?
• Do you have friends or peers who are affected by mental ill health?
• What are the signs they might be suffering?
• How could you support or help them better?
• If you describe your own mental health as poor
• Where can you go for self-help?
• You are not alone but who can you talk to?
* RESUME ▶️

## 3.8 Summarising well-being

Too long, didn’t read (TL;DR)? Here’s a summary:

Anxiety and depression are serious conditions that are very likely to affect you or somebody close to you while you are at University. There’s a one in four chance that you will be affected by mental health issues at some point in your life.

We’ve only talked about two particular mental health issues, anxiety and depression, but there are many other conditions such as phobias, obsessive-compulsive disorder (OCD), eating disorders, self-harm and more that are beyond the scope of this chapter. They do have one thing in common, and that is that talking about them is an important part of starting to develop better mental health.

If you are affected by mental ill health, talking about it is the first place to start, but often the hardest. In this chapter, I’ve outlined some ways you can help yourself alongside some of the services and people you can talk to if you need to.

Despite how you might feel, you are not alone.

Take my thoughts with you and when you look behind, you will surely see, a face that you recognise, you’re not alone.