Stopping smoking is good for your mental health

Being smoke-free helps relieve stress, anxiety and depression and gives you a more positive outlook on life. These benefits apply to all smokers, not just those with pre-existing mental health problems.

We all know that stopping smoking improves your physical health. Here are 10 health benefits of stopping smoking. But did you know that stopping smoking is also proven to boost your mental health?

Although most smokers report that they want to stop, many continue because they're convinced that smoking helps relieve stress and anxiety.

But it's a complete myth that smoking helps you to relax. The reality is that smoking actually increases anxiety and tension. Smokers are more likely to develop depression or anxiety disorder over time than non-smokers. And cutting out cigarettes triggers a big improvement in mood.

It's a myth that smoking improves mood

Why do smokers with and without mental health problems falsely believe smoking improves their mood?

Scientists think it's because they confuse the ability of cigarettes to abolish nicotine withdrawal as a beneficial effect on their mental health.

Smokers tend to feel irritable, anxious and down when they haven't smoked for a while and these unpleasant feelings are temporarily reversed when they light up a cigarette. That creates the impression that it's the smoking that has improved their mood, when in fact it's smoking that caused the psychological disturbances in the first place.

The mental health benefits of quitting smoking

Studies show that people's anxiety, depression and stress levels are lower after they stop smoking when compared with those who carry on smoking and that their quality of life and mood improves. Also, the improved levels of oxygen in the body means that ex-smokers can concentrate better.

Smokers with mental health problems

The psychological benefits of stopping smoking are just as striking in people who already have a mental health disorder as those without. Stopping smoking helps their mental health symptoms and can lead to reduced doses of anti-psychotic medicine.

This is welcome news because people with diagnosed mental health problems, including anxiety, depression or schizophrenia, are two to three times more likely to take up smoking and also tend to smoke more heavily than the general population.

It's estimated that 30% of all smokers have a mental health problem and that two of every five cigarettes smoked in England are smoked by people with a mental health problem. Smokers living with a mental health problem also have a life expectancy eight years less than the general population, very likely as a result of the physical ravages of smoking, such as lung cancer.

Stopping smoking helps more than antidepressants

One theory as to why people with mental health problems are far more likely to smoke than the general population is that they perceive nicotine gives them immediate relief from the unpleasant symptoms of anxiety, depression or schizophrenia.

But the opposite is true. People with psychiatric problems are likely to feel much calmer and positive and have a better quality of life after giving up smoking. In fact, the beneficial effect of stopping smoking in people with psychiatric problems is greater than that of antidepressant therapy for mood and anxiety disorders.

Many people living with mental health problems have successfully quit smoking and report a wide range of benefits as a result.

8 tips to stop smoking

If you want to stop smoking, contact your local NHS stop smoking services, these provide the best chance of stopping completely and forever.

Here are eight ways to boost your chances of stopping smoking. This advice applies to people with or without a mental health problem:

1. See an NHS stop smoking adviser. It's free and will massively increase your chances of quitting.
2. Use either a nicotine patch, plus one of the faster acting nicotine replacement products (such as the nicotine nasal spray) or the prescription medicine, Champix, and make sure you use them for at least six to eight weeks. Stop smoking treatments may be especially helpful for people with mental health problems if they're combined with talking treatments. Read more about stop smoking treatments.
3. If you take antipsychotic medicines and want to stop smoking it's very important that you talk to your GP and/or psychiatrist before you stop as the dosage of your prescription drugs may need to be monitored and the amount you have to take could be reduced.
4. It helps to avoid drinking alcohol or using psychoactive drugs when you stop smoking to boost your chances of success.
5. According to the Mental Health Foundation, people with depression and other mental health conditions can find it particularly difficult to give up smoking and experience stronger withdrawal symptoms and craving. Here's some advice on how to cope with cravings.
6. Because smoking is often used as a way of coping by people with mental health problems, it's important to find other ways of dealing with stress. Use these 10 stressbusters.
7. Don't worry too much about putting on weight when you stop smoking. If you eat healthily and keep active you should be able to keep weight gain to a minimum. Read how to stop smoking without putting on weight.
8. The Royal College of Psychiatrists has advice for people with mental illness on quitting smoking.

Now, read more articles about stopping smoking.

Raising low self-esteem

We all have times when we lack confidence and don't feel good about ourselves.

But when low self-esteem becomes a long-term problem, it can have a harmful effect on our mental health and our lives.

What is self-esteem?

Self-esteem is the opinion we have of ourselves.

When we have healthy self-esteem, we tend to feel positive about ourselves and about life in general. It makes us able to deal with life's ups and downs better.

When our self-esteem is low, we tend to see ourselves and our life in a more negative and critical light. We also feel less able to take on the challenges life throws at us.

What causes low self-esteem?

Low self-esteem often begins in childhood. Teachers, friends, siblings, parents, and even the media send us messages about ourselves, both positive and negative. For some reason, the message that you are not good enough is the one that stays with you.

Perhaps you found it difficult to live up to other people's expectations of you, or to your own expectations.

Stress and difficult life events, such as serious illness or a bereavement, can have a negative effect on self-esteem.

Personality can also play a part. Some people are just more prone to negative thinking, while others set impossibly high standards for themselves.

How does low self-esteem affect us?

If you have low self-esteem or confidence, you may hide yourself away from social situations, stop trying new things and avoid things you find challenging.

"In the short term, avoiding challenging and difficult situations makes you feel a lot safer," says Chris Williams, Professor of Psychosocial Psychiatry at the University of Glasgow.

"In the longer term, this can backfire because it reinforces your underlying doubts and fears. It teaches you the unhelpful rule that the only way to cope is by avoiding things."

Living with low self-esteem can harm your mental health, leading to problems like depression and anxiety.

You may also develop unhelpful habits, such as smoking and drinking too much, as a way of coping.

How to have healthy self-esteem

To boost your self-esteem, you need to identify the negative beliefs you have about yourself, then challenge them.

You may tell yourself you are "too stupid" to apply for a new job, for example, or that "nobody cares" about you.

Start to note these negative thoughts and write them down on a piece of paper or in a diary. Ask yourself when you first started to think these thoughts.

Next, start to write down evidence that challenges these negative beliefs: "I am really good at cryptic crosswords" or "My sister calls for a chat every week".

Write down other positive things about yourself, such as "I am thoughtful" or "I am a great cook" or "I am someone that others trust".

Also write down good things that other people say about you.

Aim to have at least five things on your list and add to it regularly. Then put your list somewhere you can see it. That way, you can keep reminding yourself that you are OK.

"You might have low confidence now because of what happened when you were growing up," says Professor Williams. "But we can grow and develop new ways of seeing ourselves at any age."

Other ways to improve low self-esteem

Here are some other simple techniques that may help you feel better about yourself.

Recognise what you are good at

We are all good at something, whether it's cooking, singing, doing puzzles or being a friend. We also tend to enjoy doing the things we are good at, which can help to boost your mood.

Build positive relationships

If you find certain people tend to bring you down, try to spend less time with them, or tell them how you feel about their words or actions.

Seek out relationships with people who are positive and who appreciate you.

Be kind to yourself

Professor Williams advises: "Be compassionate to yourself. That means being gentle to yourself at times when you feel like being self-critical.

"Think what you'd say to a friend in a similar situation. We often give far better advice to others than we do to ourselves."

Learn to be assertive

Being assertive is about respecting other people's opinions and needs, and expecting the same from them.

One trick is to look at other people who act assertively and copy what they do. "It's not about pretending you're someone you're not," says Professor Williams. "It's picking up hints and tips from people you admire and letting the real you come out."

Start saying 'no'

People with low self-esteem often feel they have to say yes to other people, even when they don't really want to. The risk is that you become overburdened, resentful, angry and depressed.

"For the most part, saying no doesn't upset relationships," says Professor Williams. "It can be helpful to keep saying no in different ways until they get the message."

Give yourself a challenge

We all feel nervous or afraid to do things at times. But people with healthy self-esteem don't let these feelings stop them from trying new things or taking on challenges.

Set yourself a goal, such as joining an exercise class or going to a social occasion. Achieving your goals will help to increase your self-esteem.

Where to find help for low self-esteem

Help is available if you feel you need support to start seeing yourself in a more positive light.

• Talking therapies, such as counselling or cognitive behavioural therapy (CBT), can help. Your GP can explain the different types and tell you what's available in your area. Read more about the different types of therapy.
• You can refer yourself for talking therapies in some areas. Check whether you can refer yourself to your local psychological therapies (IAPT) service.
• You can also pay privately for talking therapies – find the right therapist for you.
• Hear Dr Williams' podcast about tackling unhelpful thinking.
• Visit healthtalk.org to hear young people talking about their experiences of low self-esteem.

Dealing with jealousy

Jealousy is a normal emotion, but it can be painful and difficult to control.

Jealousy happens most commonly within a romantic relationship, although it can occur between siblings and other family members, in friendships and in professional relationships.

A small amount of jealousy can be good. For example, if it's mild and well managed, it can help a couple to appreciate each other and add to the passion of a relationship.

But extreme jealousy can destroy relationships and damage your health.

Signs of jealousy

When someone feels jealous, they feel that someone or a situation is threatening something they value highly, especially a relationship.

Jealousy can make you feel angry, anxious and threatened. You might become hypervigilant, oversensitive and possessive.

When is jealousy a problem?

Clinical psychologist Linda Blair suggests that if you're concerned about your jealousy, ask yourself three simple questions:

1) Is this feeling interfering with my normal life?
2) Is my jealousy hurting someone I love?
3) Does my jealousy control me more than I control it?

"If the answer is yes to any of these questions, then seek help through your GP," says Linda. A GP can refer you to a counsellor or a therapist if you need further help.

In some areas you can refer yourself to your local psychological therapies team.

How jealousy can be harmful

Your health

Jealousy can take over your life and lead to sleeping problems and a poor appetite.

Linda says that intense feelings of jealousy can have similar effects to chronic anxiety, including a raised heart rate, sweating and exhaustion.

If not addressed, jealousy can also lead to depression.

Your relationship

Jealousy can affect your relationship in a negative way, especially if the perceived threat is not genuine and your partner is not doing anything to cause the jealousy.

Even the most devoted partner can feel hurt, exhausted, anxious and angry that they're not trusted. Ultimately, it drains them emotionally.

How to deal with jealousy

There are some practical and positive things you can do to overcome your jealousy. Linda Blair offers the following advice:

Talk to your partner

Tell them about your feelings without blaming them. Let them know what makes you feel worried and jealous.

Prepare what you want to say, and talk to your partner in a non-threatening, neutral atmosphere. "For example, arrange to meet in a café or restaurant. You'll be more likely to stay calm," says Linda.

Try to be objective

Just because you feel there is a threat, it doesn't mean that it's genuine. Try to view the situation objectively.

Accept some uncertainty

Uncertainty is a part of relationships. You can't ultimately control someone's feelings.

How a counsellor or therapist can help

A counsellor can help you to resolve your feelings of jealousy. They will help you look at the cause of your jealousy and deal with it on a day-to-day basis.

Linda says: "Knowing the origin of the problem is not enough to resolve it completely. You need to look at the everyday triggers, why you continue to feel and act that way. A counsellor or therapist will help you understand that."

Read more about the benefits of talking therapies.

Dealing with grief and loss

Scroll down to watch a video on coping with the loss of a parent.

Most people grieve when they lose something or someone important to them.

The way grief affects you depends on lots of things, including what kind of loss you have suffered, your upbringing, your beliefs or religion, your age, your relationships, and your physical and mental health.

How does grief affect you?

People react in different ways to loss. Anxiety and helplessness often come first. Anger is also common, including feeling angry at someone who has died for "leaving you behind". Sadness often comes later.

Feelings like these are a natural part of the grieving process. Knowing that they are common may help them seem more normal. It's also important to know that they will pass.

Some people take a lot longer than others to recover. Some need help from a counsellor or therapist or their GP.

But you will eventually come to terms with your loss, and the intense feelings will subside.

How to cope with grief and loss

There's no instant fix. You might feel affected every day for about a year to 18 months after a major loss. But after this time the grief is less likely to be at the forefront of your mind.

There are practical things you can do to get through a time of bereavement or loss:

• Express yourself. Talking is often a good way to soothe painful emotions. Talking to a friend, family member, health professional or counsellor can begin the healing process.
• Allow yourself to feel sad. It's a healthy part of the grieving process.
• Keep your routine up. Keeping up simple things like walking the dog can help.
• Sleep. Emotional strain can make you very tired. If you're having trouble sleeping, see your GP.
• Eat healthily. A healthy, well-balanced diet will help you cope.
• Avoid things that "numb" the pain, such as alcohol. It will make you feel worse once the numbness wears off.
• Go to counselling if it feels right for you – but perhaps not straight away. Counselling may be more useful after a couple of weeks or months. Only you will know when you're ready.

Grieving when you have children

When you have children, you may not want to show your feelings. Sometimes this is a good thing. For example, showing anger towards their other parent during a separation can be painful for a child to see.

Reassure your child that the separation isn't their fault. Keep their routine as normal as possible, and tell them what's happening so they're less confused by it all.

However, if both parents are grieving for a loved one, it's sometimes good for children to see that it's normal to sometimes feel sad and cry.

Pay attention if your child wants to share their feelings, whether it's through talking, drawing or games. Children need to feel they are listened to, so include them in decisions and events if it feels right.

When to get help

Get help if any of the following apply to you:

• You don't feel able to cope with overwhelming emotions or daily life.
• The intense emotions aren't subsiding.
• You're not sleeping.
• You have symptoms of depression or anxiety.
• Your relationships are suffering.
• You're having sexual problems.
• You're becoming accident-prone.
• You're caring for someone who isn't coping well.

Your GP is a good place to start. They can give you advice about other support services, refer you to a counsellor, or prescribe medication if needed.

Or you can contact support organisations directly, such as Cruse Bereavement Care (0808 808 1677) or Samaritans (116 123).

Julie's story: 'I accept I'll never have a baby'

For some people, fertility treatment never has a happy outcome, and they have to resign themselves to a future without children.

'Being a member of More to Life has really helped me look towards a brighter yet child-free future.'

Julie Kendall, from Saffron Walden in Essex, 51 at the time of this interview, has finally accepted that she and her husband will never have children of their own.

"We tried for years and years to have a baby. It started with visits to the GP, then there was 18 months of temperature taking, then courses of fertility drugs, followed by two failed attempts at IVF."

Unexplained infertility

"We had what's known as 'unexplained infertility'. All the tests came back normal, and there was no obvious medical reason why I wasn’t able to conceive.

"I think it’s almost easier if you’re diagnosed with a medical reason for your infertility because you've got something to focus on, and support is available.

"Life was especially hard during our thirties as our friends produced children, but it wasn’t happening for us. We endured our fertility treatment in silence, and didn’t discuss it with family or friends. That was my way of coping.

"I found IVF so painful and traumatic that after the second attempt we both decided it wasn’t worth going through again. I was in my mid-thirties at the time."

Accepting a childless future

"My husband wanted to move on and make a fresh start, but I needed to go through a period of mourning, because realising that you'll never have children is similar to a bereavement.

"Accepting a childless future was a gradual process for me, and it didn’t happen immediately after treatment came to an end.

"A part of me hoped that I might get pregnant spontaneously, but that never happened and, now I'm 51, it never will.

"Right at the end of treatment was the only time my husband and I saw things differently. At every other stage of our infertility treatment, and up until today, we’ve been very close and supportive of each other.

"We’re lucky. Infertility and the years of treatment can wreck marriages."

Support for childless couples

"Long after we accepted we would never have children, I found the support group More to Life by accident through an article in a magazine. Here was a group of people who were also childless and had experienced many of the same things.

"Being a member of More to Life has really helped me look towards a brighter yet child-free future.

"I’d recommend the group to other women facing up to childlessness, because members are there to offer you emotional support, if you need it. Also, the social events are very good.

"It’s great to be able to spend time with other people who you know aren’t going to be talking about their kids all the time!

"If you’re a woman facing an involuntarily childless future, you have to deal with it in your own way.

"There will be times when your friends and family can’t seem to do anything right. Everything they say will be wrong and upsetting, and you will snap at them. But that’s inevitable, because you’re so emotionally vulnerable.

"I would urge other childless and grieving women to remember that you will eventually get through this. There's light at the end of the tunnel."

Further information

All about IVF

Support if you have fertility problems

Your adopted child's health needs

Children adopted from care will have experienced trauma and loss, even if they were adopted shortly after birth. Some may have additional needs resulting from physical, mental or emotional problems or disabilities.

When a possible match is suggested with you and a child, this is often an exciting time. It is important that you find out as much as possible about the child's health history and needs, so that if you decide to go ahead with the match, you will be as well informed as possible. Having realistic expectations will increase the chances of a successful adoption.

Your adopted child's health history

When children go into care (become 'looked after') or have a plan for adoption, the law requires a detailed assessment of their health. A report on their health should include information on:

• their mother's pregnancy, their birth and early development
• their birth family's medical history
• their own medical history, including any experiences of abuse and neglect, and a chronological list of any immunisations, injuries and illnesses they've had
• their current physical health, including vision, hearing and dental care
• their mental health and behaviour, including experiences of trauma and loss

It can sometimes be difficult to get all this information. For example, birth parents may not want to share information about their child if they are unhappy with the plans being made. Sometimes they may be absent or the father may be unknown. Not having full health information can make it harder to understand a child's difficulties and to predict what will happen in the future.

However, the medical assessments that a child will have had throughout their time in care means there should be existing information on their health by the time they're adopted.

Under care planning requirements for looked-after children:

• Health assessments should take place at least every six months for children aged four and under, and at least every 12 months for children aged five and over.
• Where possible, birth parents should be involved as they can help to provide more detail about the child's medical and birth family medical history.
• Based on the report of the child's health needs assessment, a health plan is developed, including any current arrangements for their healthcare and details of further healthcare that may be required.

Increasingly, it is accepted as good practice for the adoption agency's medical adviser to meet with the prospective adopters to discuss the child's health. This provides them with a better understanding of the child's needs, any gaps in their health information, and an opportunity to ask questions about the child's health. The medical adviser should then provide them with a written report, which documents what they have been told.

If the adoption goes ahead, a copy of the health assessment report will be sent to your child's GP as well as to you. You may want to discuss this with your GP, or ask your GP to talk to the medical adviser on your behalf. This can happen even after an adoption order has been made.

Parents of older adopted children often find post-adoption that medical appointments can be particularly difficult for the child as the subject of their adoption often arises, for example, if the doctor asks about family medical history. Anything you can do to help the appointment go smoothly, such as making sure the GP is aware of the situation in advance, will help your child feel more comfortable.

Developmental delays in adopted children

For a child who has been taken into care, the extent to which their development may be delayed can vary greatly. The delay can be physical or emotional, or both – the child may act younger than their age, or be unable to do things most children their age can do. Or the delay can relate to a specific area, such as their speech.

Developmental delays in looked-after and adopted children can be caused by the following factors:

• The delays have been caused by something that happened during the mother's pregnancy, such as her alcohol or drug use. This can lead to the child being diagnosed with foetal alcohol syndrome (FAS) or a foetal alcohol spectrum disorder (FASD).
• Extreme and prolonged levels of stress or anxiety during pregnancy have also been shown to be damaging to the unborn child, affecting their brain development.
• The child's environment after they are born may affect their development, such as developmental trauma caused by abuse or neglect, or both. If they are not properly cared for and stimulated, this affects the growth and development of certain areas of their brain leading to a lack of emotional development. This is often referred to as "attachment difficulties" or "attachment disorder".
• Some delays may be characteristic of genetic conditions, such as Down's syndrome.

Different children have different levels of resilience to delays caused by trauma in the womb or abuse and neglect after birth. They also have different capabilities to overcome this trauma and "catch up" developmentally.

It can be difficult to predict the long-term impact of these delays. This means that potential adopters need to accept there may be uncertainty around whether their adopted child will need specialist support services in the future. It takes a lot of perseverance, patience and determination from parents to help children overcome their difficulties, but post-adoption support is available.

Parenting neglected children

While some children in the care system may have been physically or sexually abused at some point in their lives, many of them are being looked after because their basic needs have been neglected. Studies show that neglect, such as being deprived of food or care, is often more damaging to the child than individual episodes of abuse.

Professor Peter Fonagy is chief executive of the Anna Freud Centre in London, which conducts research into attachment disorders and child mental health. He says: "The more dramatic reasons for children being taken into care, such as sexual or physical abuse, have in fact been shown to be less toxic experiences than long-term neglect. Yet neglect is more subtle and more likely to be overlooked by other adults in the child's life."

Both abuse and neglect can lead to psychological problems in children, including issues around trusting adults, which can take many years to overcome. Professor Fonagy explains that this is because they are in a state of "hyper vigilance". He says: "Children who have had bad experiences, particularly in care, are on high alert and don't believe anything anyone tells them because they don't trust them. They're shut off. They understand what they're being told but won't bring it into their own world as a truth, and they can't modify their own belief that they are not loved or that they are 'bad'."

For this reason, adopted children will not only need love and care from their adoptive parents. "There are good treatments available for a lot of childhood mental disorders," says Professor Fonagy, who has worked to improve children and young people's access to psychological therapies.

Ask your local authority or social worker about therapeutic parenting courses available to you, such as Theraplay, life story work and TAPPs courses (Trauma Attachment and Preparation for placement).

Find out more about post-adoption support.

Eating anxieties in children who have been adopted

Looked-after and adopted children often have food anxieties linked to their early experiences.

These include:

• overeating
• hoarding food
• stealing food
• problems eating certain foods, such as solids and specific textures

For example, if a child has experienced not being fed enough or regularly, this could lead to them overeating or hoarding food even after they have been placed with their adoptive family. This is because they may not fully trust that another meal will come.

Caroline Archer, author and adoptive parent of four children, has the following advice:

• Keep mealtimes as low-key as possible and set regular meal routines.
• Provide small amounts of the things your child enjoys and slowly introduce new tastes and textures.
• Never demand they eat up or finish anything – but let them know you expect them to try.
• Watch out for foods that seem to be a trigger for memories of early traumas.

Find out more about eating disorders.

Adopting a child with a medical condition, disability or special or additional needs

Some children needing adoptive families have complex medical conditions. Those with conditions such as cerebral palsy, cystic fibrosis, Down’s syndrome or foetal alcohol spectrum disorder (FASD) need parents who can meet their needs and act as effective "advocates" to make sure their children get the services they require.

Many children will also have needs relating to trauma due to neglect or abuse, in addition to their physical or medical difficulties.

Additionally, some children may have a vulnerability to some psychological conditions, such as depression or anxiety, which can be inherited. Rarer conditions that may emerge in adolescence or later, such as psychotic illnesses, may also have a genetic risk factor.

Questions to ask your child's adoption agency medical adviser and social worker

• What is the extent of my child's medical or physical disability (if they have one), and should we discuss this with a medical specialist?
• What services does my child use at the moment (such as physiotherapy or speech therapy) and how frequent are the appointments, where are they held and who co-ordinates the medical services?
• How can I care for my child's additional needs at home, as part of a daily routine?
• What changes will I need to make to my home and car to support my child's condition? Is there funding available to make this possible?
• What plans have been put in place to ensure continuity of care and ensure that all their medical records are transferred to their new GP?
• What benefits are my child and I entitled to after placement, such as a Disability Living Allowance or a carer's allowance?
• Does my child have a statement of special educational needs (SEN), and if so, what provisions does the statement include?
• Would my child benefit from remaining in a class with younger children for a while, or even staying at home? What changes or adaptations should the school make?
• If my child doesn't have a statement of SEN, is that because they don't have any special educational needs or because they don't have needs that require a statement?
• If I think my child might have special educational needs that have not yet been identified, how should I go about getting an assessment?
• Are there any hereditary health conditions in the child's birth and extended family that may appear later in their life?
• How can we get further information about the child's family and medical history in the future?

More information on adoption health needs

You may find the following resources helpful:

• The FASD Trust raises awareness of foetal alcohol spectrum disorders and has a helpline, while The National Organisation for Foetal Alcohol Syndrome (NOFAS) supports people affected by FASD, as well as their families and communities.
• Family Futures is an adoption and therapy agency offering therapeutic help to children who have experienced trauma and are living in birth families, foster homes or adoptive families.
• Post Adoption Centre (PAC) also supports birth families and relatives as well as adopted children and their adoptive families.
• Adoption Plus offers an adoption placement service, specialist therapy services and training and conferences.
• Parenting Advice for Foster Carers and Adopters (PAFCA) is run by clinical child psychologist, Dr Amber Elliott, who specialises in early trauma, adoption and fostering.
• The Adopter's Handbook, published by CoramBAAF, has information on every aspect of adoption including legal and financial matters, and schooling and education.
• CoramBAAF also publishes a series of parenting handbooks, Parenting Matters, covering issues including developmental delay and parenting children affected by their birth parents' substance abuse.
• Contact a Family is a national charity that supports the families of disabled children whatever their condition or disability.
• Young Minds is a charity committed to improving the emotional wellbeing and mental health of children and young people.
• Visit the NHS Choices sections for learning disabilities, physical disabilities and carers.

Getting medical care as a student

It's important to look after your health when moving away from home for the first time. This includes registering with a new GP and finding your local sexual health service.

Here are our five health tips for new students.

1. Register with a local GP

If, like most students, you spend more weeks of the year at your college address than your family's address, you need to register with a GP near your college as soon as possible.

That way you can receive emergency care if you need it, and access health services quickly and easily while you're at college.

This is especially important if you have an ongoing health condition, particularly one that needs medication, such as asthma, diabetes or epilepsy.

You can choose to register with any local GP. The health centre attached to your college or university is likely to be the most convenient, and the doctors working there will be experienced in the health needs of students.

Find your local GP surgery.

Other health services available

Many college health centres have good links with specialists, such as psychiatrists, sports physicians, psychotherapists, counsellors and physiotherapists.

Having trouble getting an appointment? You can also always ask your local pharmacist for medical advice and support.

They may not be at the pharmacy counter when you go in, so ask the person at the counter (who may not be qualified to give medical advice) if you can speak to the pharmacist.

Getting ill during the holidays

If you become unwell or need other medical treatment when you're at home or not staying near your university GP, you can contact your nearest practice to ask for treatment.

You can receive emergency treatment for 14 days. After that you will have to register as a temporary resident or permanent patient.

Find out how to register as a temporary resident with a GP.

You can also visit an NHS walk-in centre or minor injuries unit. These can provide treatment for minor injuries or illnesses such as cuts, bruises and rashes.

However, they are not designed for treating long-term conditions or immediately life-threatening problems. You don't need to be registered and you don't need an appointment.

2. Register with a dentist

Dental problems can't be dealt with by doctors, so make sure you register with a local dentist.

Not all treatment is free, even under the NHS. You may be able to apply for help with health costs, including prescriptions and dental care.

Find an NHS dentist.

Get help with dental costs.

3. Check your vaccinations

Men ACWY vaccination

Students are now routinely offered a vaccination to prevent meningitis W disease.

The Men ACWY vaccine protects against four different causes of meningitis and septicaemia: meningococcal (Men) A, C, W and Y diseases. It replaces the separate Men C vaccine.

All 17- and 18-year-olds in school year 13 and first-time university students up to the age of 25 are eligible as part of the NHS vaccination programme.

GP practices will automatically send letters inviting 17-and 18-year-olds in school year 13 to have the Men ACWY vaccine.

But if you're a student going away to university or college for the first time, contact the GP you're registered with to ask for the Men ACWY vaccine, ideally before the start of the academic year.

This is because you'll be at particularly high risk in the first weeks of term, when you're likely to come into contact with many new people of a similar age.

Mumps vaccination

Universities and colleges also advise students to be immunised against mumps before starting their studies.

The MMR vaccine (for mumps, measles and rubella) is part of the routine NHS childhood immunisation schedule. This means most young people who've grown up in England will have had two doses of it in childhood.

If you're not sure you've had two doses of the MMR vaccination, ask your GP for a catch-up vaccination.

Flu jab

Get an annual flu vaccination if you have asthma and take inhaled steroids. You should also get a flu vaccination if you have a serious long-term condition such as kidney disease.

4. Get contraception

Even if you don't plan to be sexually active while you're a student, it's good to be prepared.

Contraception and condoms are free to both men and women from any GP – it doesn't have to be your own – or family planning clinic.

Find your local sexual health service.

5. Rest and eat healthy food

Prevention is better than cure, as the saying goes, so you'll greatly increase your chances of avoiding your GP's waiting room by taking care of yourself in the first place.

Student life may not be renowned for early nights and healthy eating, but getting enough sleep and eating well will mean you have a better chance of staying healthy.

You'll feel more energetic and be better equipped to cope with studying and exams.

Remember to:

• eat five portions of fruit and vegetables a day
• buy wholemeal bread and pasta instead of white
• keep fast food to a minimum

Eating well doesn't have to cost a lot and is often cheaper than takeaways. Taking the time to cook simple meals instead of eating out or buying ready meals is also healthier.

Buy a student cookbook for affordable healthy recipe ideas. You might also want to try downloading the free One You Easy Meals app.

Read more about healthy eating on a budget.

Disabled Students' Allowance (DSA)

As a higher education student living in England, you can apply for a Disabled Students' Allowance (DSA) if you have a:

• disability
• long-term health condition
• mental health condition
• specific learning difficulty, such as dyslexia

The support you get depends on your individual needs and not on income.

Student mental health

Mental health problems are as common among students as they are in the general population.

But it's not just students who have a diagnosed mental health condition that can benefit from counselling.

Alan Percy, head of counselling at the University of Oxford, says: "A lot of difficulties are not caused by medical problems, but by normal life problems, such as family or relationship issues, or anxiety about their work.

"While these problems are distressing, through counselling we can help students to understand them, and then suggest strategies for dealing with their feelings."

When to get help

It's normal to feel down, anxious or stressed from time to time, but if these feelings affect your daily activities, including your studies, or don't go away after a couple of weeks, get help.

Signs of depression and anxiety include:

• feeling low
• feeling more anxious or agitated than usual
• losing interest in life
• losing motivation

Some people also:

• put on or lose weight
• stop caring about the way they look or about keeping clean
• do too much work
• stop attending lectures
• become withdrawn
• have sleep problems

Where to go for help

Talk to someone

Telling someone how you feel, whether it's a friend, counsellor or doctor, may bring an immediate sense of relief.

It's a good idea to talk to someone you trust first, such as a friend, member of your family or a tutor.

This is especially important if your studies are being affected. Many mild mental health problems can be resolved this way.

University counselling services

Many colleges and most universities have a free and confidential in-house counselling service you can access, with professionally qualified counsellors and psychotherapists.

You can usually find out what they offer and how to make an appointment in the counselling service section of your university's website. This free service in universities is available to both undergraduates and postgraduates.

Many universities also have a mental health adviser who can help you access the support you need.

As well as counselling or therapy, you may also be entitled to "reasonable adjustments" such as extra time in exams, extensions on coursework, and specialist mental health mentor support.

Student-led services

Many student unions also offer student-led services. Although the students involved aren't qualified counsellors, you may prefer to talk about problems such as stress and depression with another student.

Online self-help

There are also online self-help services you may like to explore, such as NHS Choices' Moodzone and the Students Against Depression website.

When to see your GP

For more serious or longer-lasting mental health symptoms, see your GP as you may need prescribed treatment or referral to a specialist.

If you have or develop a mental health condition that requires treatment, it's important to arrange continuity of care between your college doctor and your family GP.

A mental health adviser can support this communication. Your condition may worsen if moving between university and home results in a gap in treatment.

Therapy and counselling

Counselling and cognitive behavioural therapy (CBT) offers an opportunity to explore the underlying issues of your unhappiness or any worries you have in a safe environment, including helping you develop ways of coping.

As well as university or college counselling services, you might be able to refer yourself for NHS counselling. Search for psychological therapy services to find out what's available in your area.

The University Mental Health Advisers Network (UMHAN) represents the network of mental health advisers working in higher education dedicated to providing practical support to students experiencing mental health difficulties.

Disabled Students' Allowance (DSA)

At all UK universities, you have the opportunity to apply for a Disabled Students' Allowance (DSA).

Your mental health adviser can help you apply for a DSA, but you will need to provide evidence of a long-term mental health condition.

The DSA pays for:

• specialist equipment, such as a computer, if you need it because of your mental health condition or another disability
• non-medical helpers
• extra travel as a result of your mental health condition or disability
• other disability-related costs of studying

Even if you decide not to apply for a DSA, the mental health adviser will still be able to let you know what support is available.

Drugs, drink and mental health in students

If you're feeling low or stressed, you may be tempted to drink more alcohol or relax by smoking cannabis.

Consider how this may make you feel in the longer term though, as your mood could slip, making you feel a lot worse.

Some cannabis users can have unpleasant experiences, including confusion, hallucinations, anxiety and paranoia.

There's also growing evidence that long-term cannabis use can double your risk of developing a serious mental illness, such as schizophrenia.

Ecstasy and amphetamines can also bring on schizophrenia, and amphetamines can induce other forms of psychosis.

Any underlying mental disorder could be worsened by drug and alcohol use.

Read more articles about drugs.

Student stress: self-help tips

Starting university can be a stressful experience. How you cope with the stress is the key to whether or not it develops into a health problem.

Watch a video on how to cope with stress

Stress is a natural feeling, designed to help you cope in challenging situations. In small amounts it's good, because it pushes you to work hard and do your best, including in exams.

Leaving home to start your studies can involve some stressful changes. These might include moving to a new area, meeting new people and managing on a tight budget.

Signs you might be stressed

The first signs of stress are:

• irritability
• sleep problems

Too much stress can lead to physical and psychological problems, such as:

• anxiety – feelings ranging from uneasiness to severe and paralysing panic
• dry mouth
• churning stomach
• palpitations – pounding heart
• sweating
• shortness of breath
• depression

Things that can help with stress

Short periods of stress are normal, and can often be resolved by something as simple as completing a task – which cuts down your workload – or by talking to others and taking time to relax.

Some of these suggestions might help:

• Work out what it is that's making you anxious. For example, is it exams, or money or relationship problems? See if you can change your circumstances to ease the pressure you're under.
• Try to have a more healthy lifestyle. Eat well, get enough sleep, exercise regularly, cut down on alcohol, and spend some time socialising as well as working and studying.
• Try not to worry about the future or compare yourself with others.
• Learn to relax. If you have a panic attack or are in a stressful situation, try to focus on something outside yourself, or switch off by watching TV or chatting to someone.
• Relaxation and breathing exercises may help.
• Try to resolve personal problems by talking to a friend, tutor or someone in your family.
• Read about how to cope with the stress of exams.

For more tips on beating stress, check out these 10 stress busters.

The NHS Choices Moodzone has eight free mental wellbeing podcasts or audio guides that may help you when your mood is low or you're facing an anxious time in your life.

This anxiety podcast tackles stress that arises around revision time and exams.

Professional help for student stress

Long-term stress and anxiety is difficult to resolve by yourself, and it's often best for you to seek help.

Don't struggle alone. Anxiety can seriously affect your academic performance, and that's not only distressing for you, but means a lot of wasted effort.

Find out more about tackling student mental health issues.

Talking to children about feelings

If you're worried about a child, encouraging them to talk can be very helpful, whether you're a parent, grandparent, friend or teacher.

If you think a child you know has a problem, it can be hard to know how to start talking to them about it.

When there are problems at home, such as parents fighting, divorce or a death in the family, children can become withdrawn and upset.

Being able to talk to someone other than a parent is sometimes very helpful for children. Grandparents, uncles, aunts, teachers or even a counsellor can all offer support.

Look for clues in their play

Children express themselves through play as well as words. You can learn a lot about how they're feeling by simply spending time with them and watching them play.

Stressed and upset children often play fighting games with their toys. Comment on this by saying, "There are a lot of fights going on" or "It seems pretty frightening". This can help to get them talking about what's bothering them.

Even if you don't start a conversation, you'll be making the child feel more comfortable with you, paving the way for them to open up to you about their problems.

If you can get them talking, gently ask what's wrong. But if the child doesn't want to open up, let the subject go, then repeat the process at another time until they're ready to tell you what's bothering them.

If a child is too frightened to talk

If you're worried that a child you know might be being abused at home, it can help to ask a question like, "Is mummy getting very cross with you? You can tell me about it if you want to".

A child might not understand that they're being abused. They may simply see it as a parent being angry or annoyed with them.

Children who are being sexually abused often don't talk about it because they think it's their fault or they have been convinced by their abuser that it is normal or a "special secret".

See more signs of child sexual abuse.

Children will often ask if you're going to tell anyone about what they've told you. Never promise not to tell, but explain that you'll only tell other people who want to help.

If you suspect abuse, encourage them to call ChildLine (0800 1111) or ring the NSPCC yourself (0808 800 5000) and get advice about how to report it.

'Children are aware that they're behaving badly. It’s important to find out why, and reinforce the message that it's unacceptable'

If a child is aggressive or misbehaving

If a child is fighting or being aggressive, they're doing it for a good reason, and talking may help you discover the reason.

Start by telling the child that their bad behaviour is unacceptable and why – for example, because it will harm other people or get them into trouble. Then offer them the chance to talk about why they're angry.

This might not work instantly because an angry child might not listen to you straight away. Don't give up. Children are aware when they're behaving badly, and it's important to find out the reasons why.

See more tips on dealing with child anger.

If your child is grieving

Young children don't always understand what death means. It helps to explain it by saying, "Nana's died. She's not going to be with us any more".

Watch children carefully if someone close to them has died. If they seem tearful or withdrawn, encourage them to open up about how they're feeling by talking about the person who's died.

You could say something like, "It's very sad that Nana has died" or "I feel sad that Nana has died, and sometimes it's hard to understand why people die".

See more about children and bereavement.

If you're still worried about your child

If you are still concerned about your child after talking to them, see your GP for further advice.

See some tips on talking to teenagers.