Thursday 7th March is University Mental Health Day 2019. This year’s theme is the power of using your voice. The day is all about encouraging people to share their stories and helping to shape the future of student mental health. At Addiction Helper, we want to raise awareness about dual diagnosis amongst university students.
Dual diagnosis is often misunderstood and poorly diagnosed. Often people who suffer try to hide or minimise their symptoms. Even very qualified GPs and health professionals can find it challenging to unravel the signs and symptoms of mental illness with those of addiction.
To increase awareness on University Mental Health Day 2019, this blog includes Cate’s personal story of having a dual diagnosis as an undergraduate. If you’re suffering now with a mental health disorder and addiction, we hope Cate’s story encourages you to speak up about dual diagnosis, so that you can get the help you need to recover.
What Is Dual Diagnosis?
A dual diagnosis is where a person has a diagnosed mental illness and co-occurring addiction(s). Examples include:
- Clinical depression and alcohol addiction
- An eating disorder and cocaine addiction
- Schizoaffective disorder and cannabis addiction
- Bipolar disorder and prescription drug addiction (where a person regularly uses medication beyond the prescribed dose or they supplement their prescription with other drugs).
You can read Addiction Helper’s full guide to dual diagnosis here, including signs and symptoms, how it affects people’s lives and how it is assessed and treated.
Cate’s Story of Dual Diagnosis at University
To mark University Mental Health Day 2019, Cate has spoken to Addiction Helper about her dual diagnosis. Cate describes how her mental illness and addictions developed and how they affected her university years.
“In my teenage years, I had several periods of clinical depression and anxiety. I was prescribed anti-depressants and took them on and off from the age of 16. In that time, my GP never asked me about my alcohol and drug use. And I certainly didn’t volunteer the information. From the age of 14, I was regularly drinking to get drunk, as well as experimenting with drugs like cannabis, ecstasy and cocaine. Cannabis made me feel paranoid and sick, so I only used that a few times. But I became a regular user of ecstasy and cocaine, as they made me feel more confident in social groups. I liked being able to stay up all night and dance at parties, as well as feeling more in control. I just seemed to like myself more on drugs – until they wore off.
“When I went to university, I moved over 200 miles from my home town to Leeds. It was a much bigger city than where I grew up. I didn’t know anyone. I was really excited to be starting university but also terrified about the change. I didn’t tell anyone in my family how I really felt about moving so far away. I packed a big suitcase and went up on the train by myself. In many ways, it was a really impulsive decision to move so far away. I guess I wanted to assert my independence from my family but I didn’t really think through how I’d feel when I arrived in Leeds.
“My drinking escalated the moment I started university. I turned to alcohol to cover up my depression and anxiety, which I wanted to hide from my peers because I was embarrassed about it. I wasn’t taking any medication when I first started my course, so alcohol was the main way I coped on difficult days. I believed that drink would help me to talk to new people and make some good friends. In halls, my room was on the same floor as several big drinkers. I spent most of my free time with them and straight away, we were drinking to get drunk together. It felt like friendship when I was drinking – but in the mornings, I always felt uncomfortable around so many new people. I always felt like I had something to prove to them.
“With drugs, at first I couldn’t easily get hold of ecstasy and cocaine in Leeds – partly because I didn’t know anyone who was dealing those drugs but also because my finances were all over the place. After the first term at university, I started to bring supplies back to university after the holidays. I also found people on campus who could get hold of amphetamines, which were cheaper than ecstasy and cocaine.
“I did alright in my studies, turning up to most of my classes and submitting coursework. Sometimes I needed extensions but not often enough to alert tutors that something was wrong. But all the time, the symptoms of my mental illness became increasingly difficult to handle. I would wake in the morning with terrible hangovers, feeling really low. I developed body dysmorphia at university, perceiving myself as physically unacceptable to other people. It was such a vicious cycle, drinking and taking more drugs to cope with feeling so uncomfortable – then feeling worse because of the effects of substance abuse. Eventually, I got another prescription from a local doctor for anti-depressants – but again, there were no questions asked about alcohol and drugs.
“After two years, university came to a premature end for me. I did leave with a qualification but it wasn’t the degree I intended to achieve. I moved back to my family home and took a job in a call centre. Initially, I was angry with myself for dropping out and my family couldn’t understand what had happened. “Finally, I started being more honest with my GP about my drug and alcohol use, as well as the mental health conditions she already knew about. That was the first time I came to understand myself as an addict, as well as someone with depression and anxiety. That’s when things really changed for me.
By being truthful, it opened up doors to helpful information and support. I told my parents about what was really going on. With their help, I started looking into addiction treatment. I had a telephone assessment to start with and I was totally upfront about everything – the depression, anxiety, drugs and alcohol. It was such a relief to tell the whole story and find out about the choices I had for treatment.
“For me, dealing with my dual diagnosis has been a step-by-step process. It was absolutely vital for me to spend a month in residential addiction rehab. The centre I attended had a very good understanding of dual diagnosis. They advised complete abstinence from drugs and alcohol, in order to achieve a more stable recovery from mental illness.
“Recovery has not been a straight line for me – there have definitely been ups and downs – but I’m really proud of myself for achieving a lasting recovery from drug and alcohol addiction. I haven’t touched a drink or a recreational drug since going through rehab, over 5 years ago now. I have learned so much about my mental health in my recovery, including when I need to get extra support from peers or my GP. Sometimes I go through bad patches with my mental health, usually when I’m putting far too much pressure on myself. But I’ve become much less reliant on medication, since giving up alcohol and drugs. And I’ve really benefited from therapies including cognitive behavioural therapy, 12 step therapy and trauma therapy.
“Today, I know that my depression and anxiety came before my substance addictions. I turned to alcohol and drugs to cope with the horrible feelings I had – but that just led to a dual diagnosis. As a teenager, I didn’t have the awareness, let alone the vocabulary, to describe what was really going on. Now, I see that none of this experience has been a waste. I’ve learned an incredible amount about mental health, addiction, recovery and self-care. And I use that experience to help other people in their recovery from dual diagnosis.
“On University Mental Health Day, what I’d love to say to university students with a dual diagnosis is this – please do not go it alone; there is no need to cover things up; it’s really common to suffer from mental illness and/or addiction. When I first started telling people the truth, I thought my life was over. In reality, it was the beginning of the best period of my life so far. I’m so hopeful for the future now. Life might have taken a few unexpected turns but I see now that my health is the number one priority. I’m so proud of how I’ve turned my life around.”
Why Are University Students at Risk of Dual Diagnosis?
Going to university can be an exciting and transformative time, but for some students, the level of expectation and change is very daunting. The majority of university students are young people. As in Cate’s experience, often it’s their first experience of living away from home, further away from family support. Many students move to a brand new town or city. Some even go abroad to pursue their Higher Education goals.
When settling into university, there are many adjustments to make. Not only do students need to adapt to the routines and requirements of their academic life, but they also need to manage their finances (including taking out loans or finding a job to fund their time in education). They also need to establish themselves in new accommodation, make new friends, get to know new locations, eat properly and sleep well.
Student Minds say that common pressures on students include irregular sleeping patterns, poor diet, lack of exercise, work deadlines and drinking too much alcohol. All of these are risk factors for developing mental illness.
Additionally, there are students who enrol at university every year with a pre-existing dual diagnosis. They may or may not have an effective treatment plan in place. Without proper medical care and support, people who start university with a dual diagnosis are at risk of worsening symptoms.
How Many Students Have Mental Health Disorders?
According to the organisers of University Mental Health Day 2019, “there are over 2.3 million students studying in UK universities, with many of these students experiencing academic, social and financial pressures.” Nearly 50% of young people enter Higher Education and around a third of university students report “clinical levels of psychological distress.”
Students most commonly experience anxiety and depression but they also experience eating disorders, self-harm, OCD, bipolar disorder, psychosis and personality disorders.
How Many Students Take Drugs and Drink Too Much Alcohol?
In 2018, a National Union of Students survey found that two in five university students were drugs users. Cannabis was by far the most widely used drug. Students also used ecstasy, nitrous oxide and cocaine. The National Union of Students Alcohol Impact Survey 2017-18 found that 25% of respondents report drinking alcohol with the intention of getting drunk at least once a week. Of those, 6% reported purposefully drinking to get drunk more than once a week.
In the same NUS report, 79% of participants agreed that drinking and getting drunk are part of university culture. However, 78% said they don’t have to get drunk to have a good night out. This data suggests that around 1 in 5 university students may drink excessively, whether that’s binge drinking or consistently consuming more than safe alcohol limits.
Regarding alcohol abuse in Irish universities, research published in 2015 found that 65.2% of men and 67.3% of women reported hazardous alcohol consumption. The study, which had 2275 undergraduate participants, also showed that students who drank excessively were more likely to report illegal drug use.
For more, please read the Addiction Helper Students University Guide to Alcohol and Drugs. On this page, we explain the effects of drugs most commonly abused at university. It’s important to understand that all drugs with psychoactive effects can lead to psychological dependence, which is often harder to break than physical addiction.
If you’re a student at university who is affected by a dual diagnosis, please don’t put off getting the help you need. Contact Addiction Helper to discuss your situation and treatment options.