Revision on; Summertime brings sunshine, but also gathering clouds of

SPRING is marching into summer, daylight is stretching longer into the evening and we are treated to welcome, if short-lived, bursts of sunshine. Yet just as sufferers of seasonal affective disorder begin to come out of their shells, another group of society plunges into mental turbulence. All over the country, school and university students have their heads down to swot for summer exams, and anxiety levels shoot up.

While that may always have been the case, these days the psychological pressures on students and young people appear to be greater. Although more of them are flocking to further and higher education, most are facing greater financial burdens than their predecessors and anticipating to an uncertain future in the job market.

Recent research by the Mental Health Foundation, in old and more recently established universities in England, showed that over half of students had possible clinical anxiety, with 46 per cent recorded in men and 64 per cent in women and possible clinical depression noted in 12 per cent and 15 per cent respectively. This compared to 1987, where up to 25 per cent of students showed "significant emotional disturbance". Student suicides also rose from 2.4 per 100,000 in 1983/4 to 9.7 in 1993/4.

Staff at the University of Edinburgh's Counselling Service have already noticed anxiety levels rising in anticipation of this year's exams. Since the service opened 30 years ago, increasing numbers of students have sought help from its trained counsellors, particularly in the spring and summer semesters. Part of that is due to the diminishing stigma attached to seeking professional support for psychological problems, but director Craig McDevitt believes much of the change is due to external trends. "There is a lot of anxiety, because in order to get the really good jobs or postgraduate work you have to have an excellent degree," he says. "On top of that, a very large percentage of students are working as well as studying to keep themselves together financially. That is a huge stress."

Evidence suggests that today's more competitive society is affecting the mental health of young people in general. Depression, suicide, suicidal behaviour and substance misuse have all increased among this age group, according to the Mental Health Foundation. While issues such as divorce and family instability play a role, anxiety about the future is a key factor, which tends to reach a critical point around exam time. Teachers drum into children the importance of passing exams in order to get into the job market. This may exacerbate worries over other problems during the difficult teenage years.

"We know from work we've done in schools that young people get most anxious about exam stress," says Anne Houston, director of Childline Scotland, a helpline providing support and advice for youngsters. "All the issues about expectations, not wanting to let people down, concern about the future and jobs all come together at that time." Often children feel unable to talk about their feelings and instead bottle them up, until in some cases they lead to clinical illness.

Part of the problem is that adults fail to recognise depression and anxiety in children, associating the conditions with adult problems. If a teenager has no friend or teacher to confide in, the situation can escalate. Young men are particularly likely to put off seeking help - a fact starkly demonstrated in Scotland by rising numbers of 15-24 year olds who resort to suicide. There were ten suicides for every 100,000 males between the ages of 11 and 24 in 1986. In 1998 there were 13.5 recorded in the same group.

There are no easy solutions. Talking to someone - whether a friend, a trained counsellor or a doctor - can help tackle the source of anxiety or depression and develop a coping strategy for the exam period. Experts advise breaking revision down into manageable chunks and taking time out to relax, exercise and eat healthily.

If problems emerge close to exams a visit to the GP is most appropriate as prescribed drugs like beta blockers or anti- depressants can help relieve the symptoms quickly. In addition, the date of the illness is recorded, which may be crucial if the student fails the exam and needs to appeal later.

A support network is emerging which can help students of all ages deal with anxiety and depression. Most universities offer a counselling service and helpline agencies such as Childline and The Samaritans can also provide advice. But in reality most young people turn to such measures as a last resort and many will not even consider them. The challenge now is to integrate mental health information into education programmes alongside standard components like nutrition and exercise, to enable future generations of young people to better cope with the new pressures of the 21st century To contact Childline Scotland, call 0800 1111

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