The further one climbs up the academic ranks, the more likely mental health problems are to occur. Sometimes, they start at undergraduate level. High-pressure courses are especially prone to inflicting mental health issues on students, whatever the stage.
Peers, parents and relatives must always be aware of a student’s possible reaction to stress, such as low self-esteem or anxiety: the symptoms may include abnormal sleep (either too little/ much/erratic), bad eating habits, sensation of pain, excessive scratching, gastrointestinal symptoms and, most significantly, mood changes. They may be unable to focus on their work as well, as their memory is badly affected, and logical reasoning becomes very limited.
Further stresses in life can become much more difficult to deal with, and sometimes even small tasks can become a huge issue: for example, when deciding what food to buy, or whether to go out or not.
It can often manifest itself as a withdrawn kind of behaviour. This can be observed when a person shows an obvious reluctance to talk or share feelings, general lethargy or an apathetic approach to simple things.
Overloaded curricula can also be a contributory factor
Smoking, alcohol and drugs may become a coping strategy. Relationships may fail, as the stressed student can start to become very impatient or may start showing lack of empathy towards others. Anger is a very frequent occurrence, especially where the student feels frustration or hurt. Sadly, these feelings or moods can leave a student lashing out at their nearest and dearest.
It is often said that mental health problems affect the closest people most. From an outsider’s point of view, there may be an element of truth as they watch their loved ones become progressively more distant, introverted and unpredictable. The vital intra-family/friendship bonds can deteriorate, if not dissolve – the worst thing for someone suffering stress.
However, it is worth remembering that the person involved will be suffering the most, as usually they are unable to see a way out of their mental maze.
There are some predisposing factors to these problems. Those with inadequate support systems, especially pastoral care from university that can nip problems in the bud before they escalate.
The lack of a supportive network like parents, relatives and friends can make a difference too: those who aren’t related sometimes may be better placed to identify changes in the person.
Overloaded curricula can also be a contributory factor: being overwhelmed by demands, or feeling unable to understand your work can induce further such negative emotions.
Sometimes attitudes projected onto those suffering, in the form of put-downs, insults or simply a negative attitude to the student’s ambitions, can further increase the burden on the student. One more issue is that some students are less likely to seek help until it’s far too late. Medical students are notorious for this!
It is important to highlight stigma. Sadly, societies where families are not open to learn or discuss mental health problems, are ideal breeding grounds for problems to go undetected. It is important for anyone to be able to express their ideas and problems without fear of mockery, stigmatisation, retribution or being made to feel weak or stupid, no matter what the problem. Failure to do this can lead to further anxieties and may lead sufferers trying to self-diagnose using unreliable resources, like the internet and trying to self-treat, which can easily go wrong. With regard to personality traits, the more self-critical types are more prone.
A sad side-effect of severe mental disorders that are left inadequately treated is suicide. It is a shocking yet true statistic, but suicide rates are higher in the student population than in the average population. An illness that has no ‘physical’ cause as the average person may understand it, can lead to death.
Anyone is vulnerable to depression and anxiety at any time, but special attention should be given to students as they can sometimes be overlooked even while they are at school where predisposing factors may develop. Sometimes, all it takes is a smile, a hug and a quick chat to make a world of difference.
Julia Shaaban is an international medical student at the University of Malta.