Tomorrow's Pharmacist October 1999 p49-51
Edited by Pamela Mason

Student health

Student health - looking after number one ...

By Imogen Savage, PhD, MRPharmS

Leaving home and becoming a university student for the first time can be a stressful experience, which may affect your health. This article provides practical tips on how to look after yourself.

running Pharmacy student Jaina was feeling pleased with herself. It was her first party as a fresher, and she seemed to be having a lot more social success than her new friends from down the corridor. Jenny and Zarah, both doing sociology, were still dancing round their handbags and trying to pretend they didn't mind. But that great looking bloke was definitely trying to chat her up; he wanted to go somewhere quieter to talk.
"You're doing pharmacy aren't you?" he asked. She nodded expectantly, planning some general chit-chat about her new course. And then he told her all about the headaches he'd been getting. The GP had sent him for lots of tests but they hadn't found anything. What was the strongest painkiller he could buy?
Pharmacy students, like other trainee health professionals, often find themselves in situations like this one, and it doesn't stop when you qualify! People expect them to know things they haven't had a chance to learn yet.
Luckily, Jaina remembered what her pharmacist dad had often said: people don't always tell the doctor everything. So she asked her new friend a bit about himself. It turned out that his father had been made redundant and he was worried sick about how he could continue at college. He had taken a part-time job to boost family finances but his college work was really falling behind. He hadn't told anyone at college because he was afraid they would make him give up his job. He really couldn't see a way out.
Jaina and her friends are fiction, but the situation - or something like it - is real. Today's students face many pressures - pressure to succeed, fear of failure, money worries and competition for jobs. And sometimes, these pressures result in health problems. More often than not, it will be the student health and welfare services that spot them first, although there is no reason why a first year pharmacy student shouldn't pick them up.
Generally speaking, students are a pretty healthy bunch - in fact, right now, you are probably as fit as you ever will be. The average person coming straight from school has had years of regular meals, school sports activities and reasonably early nights. Childhood illnesses are well behind you, and nasties like heart disease and cancer are way in the future. Living in halls of residence does increase risk of an infectious disease - usually colds and 'flu - but apart from that, you are less likely to be ill than the general population.

Adjusting

So your main health problems as a student will have more to do with learning to adjust to life away from home and family. Suddenly, you are responsible for organising your life. Everything is new - new teachers, new classmates, and a different way of working from schooldays. Some people find this exciting, while others find it confusing and a bit lonely.
This feeling should soon wear off - they say the first term is the worst! But if it doesn't, don't bottle up your feelings. Talk to someone about it. If you feel that your friends won't understand, then try your personal tutor. It's his or her job to listen to you.

Course work

If you are having problems with the course work, tutors are definitely the best people to help you. Don't be afraid to tell your lecturers if you are stuck. It is very important for us to get this "feedback". If students are struggling with our course work, maybe the fault is ours.
If you feel you can't talk to the teacher concerned, then you could ask your tutor, or the confidential student counselling service. Remember this is available to any student who has problems, whatever they are.

Mental health

There is not a huge amount of information on mental health problems in students - although your university may be one of those doing research in this area. But in young people as a whole, depression, eating disorders and abuse of alcohol and psychoactive drugs are on the increase. And university counselling services say they are seeing more and more students with quite severe psychological problems.
Student life is getting tougher, family structures are falling apart and the job market is changing. We all feel that bit more uncertain about the future. So, maybe it stands to reason that depression and anxiety are on the increase. And maybe that's why more people are using alcohol and "illicit" drugs.

Drugs and alcohol

Smoking kills In 1996, over 3,000 second year students from 10 UK universities completed an anonymous questionnaire on their drinking, drug use, and mental health. The survey, done by Newcastle university, found the vast majority (89 per cent) of students drank, and three out of 10 were binge drinkers. Over half had at least the occasional joint and a third used other drugs - mostly psychostimulants like Ecstacy. Not surprisingly, nearly all these students said they took alcohol or drugs for pleasure.
What people in counselling services ask is: is this drug use just part of the normal growing up process? (Nearly half the students in the Newcastle survey said their drug use had started at school) Or, are students really taking drugs to try to soothe deeper-seated problems? And what are the risks of a person becoming dependent?
Either way, counsellors believe that students need down-to-earth information about drugs, their side effects and the social and legal consequences that using them may have. A recent survey at Birmingham university showed that student users may prefer telephone help lines, or non-university advice centres. Whatever develops, the experts feel that students themselves are the best people to raise awareness, and encourage other students to use the health services which are on offer.
So, new pharmacy student - it's over to you!

To do list

Register now with a local GP, via your college student health service. This will make it simpler to get treatment when you need it. If you need to see your old/previous doctor when you go home (and home is outside the university catchment area), you can sign on as a temporary resident.
Check out your student medical centre, and what it offers you. There will be other people you can see as well as a doctor. Ask about dental services too - better to find out before you need emergency treatment!
If you are worried about your health, or about any medicines you are taking, your college teacher-practitioner should also be able to help. Every school of pharmacy will have at least one person who both teaches and works as a "proper pharmacist" . Giving health advice is part of their job.
Try and eat healthily. The gold standard is five portions of fruit or vegetables a day, but the average (non-student) person probably manages three. Experts say non vegetarian students eat even less. A healthy diet doesn't have to cost more than your favourite fast food. It can take a bit longer to get ready, but that's a good thing. Eating spicy or fatty food on the go is not great for the digestion or the bowels.
Balance time for work and time for fun. If you find keeping up with deadlines a struggle, talk to your tutor about it. Don't let work build up.
If you drink alcohol, learn to know your own limits. Everyone has their own "dose response curve" to this very old and widely used social drug Used sensibly, it can enhance a good night out. But bar binges do not enhance brain activity at next morning's tutorial ! Getting legless increases the risk of accidents and violence (particularly in men), and can lead to sex you didn't really want. Alcohol can also make you feel depressed.
Some problems are easier to talk about with someone you don't know at all. Keep an eye on the noticeboards for telephone helplines, for example, for advice on sex, contraception, drink or drugs. You may like these better than a face-to-face chat. There should also be a night-time listening and advice service, run by students (in London it is called London nightline and it operates every night in term time).
Watch out for your friends. If someone doesn't turn up at a class, check if he or she is OK. Meningitis is rare, but the symptoms - initially like 'flu - can develop fast. Hiding away from friends can also be a sign of depression or other serious psychiatric illness. So whatever you do, don't ignore it.

Dr Savage is lecturer in primary care pharmacy, King's College, London.

Tomorrow's Pharmacist October 1999 p49-51 Edited by Pamela Mason