As an Association, we believe that the mental health of pharmacists, pre-registration trainees, and  students is of the utmost importance. We are therefore asking our members to share their stories  around mental health in the hope that we can encourage us all to speak out and support each other,  and lobby the government to invest more in the mental wellbeing of pharmacists and pharmacy  students. 

You are welcome to share your story anonymously. Please follow this link to share your story with  us. 

This publication will focus on some responses we have received thus far regarding the impact of  COVID-19 on pharmacy students' mental health, which we are sharing to shed a light on the  challenges facing pharmacy students today, and highlight what support is out there for us. 

There are six stories shared within this publication: 

1. Returning to a different university life 

2. Adjusting to online university 

3. Staying motivated 

4. Starting university as an international student 

5. Anxiety and the pandemic 

6. Dealing with a loss of structure 

1: Returning to a different university life

I have always been very sociable and active in uni, work and multiple extracurriculars. This year has  been one of the most challenging experiences of my life. Working in a community pharmacy whilst  trying to do well in my final year of the MPharm, despite having no respite through my normal  hobbies or social events, has been tough. I've found that no matter how hard I try to get work done,  I'm so apathetic to it that I can't get words onto paper. 

Individual staff within the university have been lovely and done an excellent job showing their  support for us; however, I feel let down by the university as an organisation. Last year our grades  were scaled down after working really hard to get through exams in a pandemic. The university then  removed the no detriment policy for 2020-21, despite nothing about the situation changing: our  timetable is still up in the air, we are still receiving most of the content online, and our exams are all  virtual. We appreciate how hard our lecturers are working on trying and making content accessible  to us and appreciate the changes to extenuating circumstances for those unlucky enough to get  COVID-19; however, there hasn't been enough acknowledgement of how the lack of collaborative  learning and small interactions (venting, joking, hugging or just a smile in the corridor) between  course-mates has impacted student wellbeing and performance.

Usually, I'm really invested in my learning and quick to voice my opinions or ask questions. This year  is the first time I've felt genuinely apathetic to most of what I'm doing. The inability to plan out what  to study and when organising revision sessions with friends and spend more than 2 hours in the  library has a massive impact on the quality of work I'm producing. Most importantly, it's leaving me  feeling utterly disinterested in my final year. This year has just felt like one continuous breakdown  because graduating in a pandemic is hard. 

TIPS: Try to socialise in any way you can to keep you sane. 

2: Adjusting to online university 

The struggles and injustices of online teaching have been immense. As university students, we have  had to deal with online teaching (whilst adequate, does not make up for face-to-face teaching),  alongside paying rents, food and bills. We have been forced out of our accommodations early by the  government, with no refunds or rent deductions; made to do online exams with little support from  our universities and used as a scapegoat by the government when COVID cases began to rise again.  Many of us have given up our own time to help out at pharmacies and hospitals during the  pandemic, yet we have had no government recognition or help. 

Our lecturers have been helpful, but they are often kept in the dark, so they cannot update us  quickly on changing circumstances. Constant anxiety, frustration and depression have caused me to  feel unmotivated to study or feel interested in wanting to learn. The feeling of being left in the dark  around the aspect of my studies has also made me feel lonely. 

TIPS: Surround yourself with a good group of friends. Have constant virtual communication with  family and friends. Have regular chats with your personal tutor. 

3: Staying motivated 

I think at the start of this new university year, I found it very hard to stay motivated to work. I was  used to getting up and going to lecturers seeing my friends and other students work makes me  motivated to work. I also was used to writing lots of information in lecture handbooks and printouts,  so it was a struggle to switch to using a laptop full time. Doing work all online, I found it hard to stay  on top of my lectures as we can do them at any time I worked at random times. 

Other people were in the same situation as me, so when doing group work and talking to the other  group members, they had similar struggles. Talking through work with others motivated me to do  more. Learning how everyone had different methods of revising helped me to try new methods of  learning. 

I think this year has been a lot more lonely than previous years studying pharmacy as I'm used to  seeing my friends or other students daily. I think the lack of social interaction has been quite  isolating. Having scheduled workshops and group meetings really helped me stay on top of my work.  Talking to other students facing similar problems and struggles with online learning during group  meetings has really helped reduce isolation. 

TIPS: Talk to other students in your course or in your year to stay motivated to learn. Sign up for  more volunteering or jobs to meet new people. Talk to each other about the struggles and tips for  coping with this year.

4: Starting university as an international student 

I am an international student who joined uni during the pandemic. I came 3 days before my course  started. My country had closed its border for months. How did I get there? I booked a flight before  getting my visa. My visa was estimated to come on the same day as this last special flight (packed  mostly with students) to Heathrow, and it was the last one my country allowed. Moving in 3 days  before my course was immense stress for me, particularly not familiar with the area and somehow  due to a form of language barrier caused by my shyness. But I managed. 

The worst part.... homesickness! I was not a dependent person, but it was a challenge I knew I had to  face. Tears all night, calling home, friends abroad, and saying I'm okay to my surroundings, but as the  phone call ended, I was missing home more. The first few months were mentally straining. I wanted  

to go back home and play with my dogs. As the days went by, I became mentally more stable. Time  healed me somehow, despite being a very sensitive person. Being homesick is a cycle, it comes and  goes, and it's unavoidable. With the pandemic and courses moved online, there were no doors open  for me to forge a friendship with someone. So, I had no real-time friends. 

I alleviated myself with window shopping and food on my own, alone. I felt better, but it was only a  small rescue door as lockdown came and everywhere was closed. The white nights came back, and I  fought. I also had to cope with a long-distance relationship with my lover back home. My first  relationship and I did not want to let go. Being far created a distance, and I became entangled in  almost a year of a toxic relationship with that person where I felt mentally abused and manipulated,  and my lover tried to commit suicide. No one knew my relationship with that person. I cried,  therefore, I dealt. I said no to all the toxicity coming my way and all the fights I endured every month  because of that person. 

Soon, Christmas approached, and my heart shattered little by little more. A door closed as one of my  flatmates went. The pains get deeper and deeper. The ultimate recognition that I will be alone while  everyone will be home for Christmas. I was here on my own, fighting alone again. But why? I could  not go home for Christmas because of my country lockdown restrictions. Till now, I will say that my  journey is a dark tunnel, but I'll find the light. COVID made it really hard for me. I also had to deal  with a flatmate having COVID who was careless about self-isolating, but I did what I could to stay  safe (I did not want to feel guilty for transmitting it to a flatmate of mine who planned to go home  for the festive season and meet her blind and old grandma). What drives me to cope and deal with  what comes in my way alone is my love for my studies and my vision for my future. 

TIPS: I would say, getting closer to my flatmates helped me. We had a routine of Friday night  gathering, and it was a break for me. It did not solve my problems, but at least I had them by my  side. I would not share my stories with my surroundings because I rather see them smiling with me  and enjoy the moment while I can. It is a lonely journey that will shape me, and I will grow and learn  from it. Acknowledging the hardship, going through it and learning from it. 

5: Anxiety and the pandemic 

I've been suffering with anxiety for a long time, but things really became too much when everything  went up in the air with coronavirus, and I suddenly moved back home. I started feeling unable to  leave the house without having an anxiety attack, and the smallest things would cause a breakdown  and leaving me crying and shaking and thinking I was going to die. At this point, I knew I needed to  seek support and contacted my GP, who was really supportive and made sure I was comfortable 

with what we decided. I tried propranolol, but I didn't find it helpful, and I moved onto an SSRI and  have found I can cope so much better. 

The university has been very supportive; I have had numerous talking therapy sessions for free, and  also, since contacting the lead on my course have had a support recommendation put in place which  allows me extra time in exams and in communication style exams I can sit them first, and it is so  helpful to know I have these things even if I don't need to use it that day. 

It has had a massive impact as it has made things like placement so much more challenging and  almost impossible for me to cope with, and I have had to leave dispensing sessions as I find it  difficult to cope in the environment. It also leaves me exhausted, making it even harder to study in  my own time, especially with the flexible learning in place at the moment. 

TIPS: Don't be ashamed to ask for help and medication- honestly, it is a stigma that needs braking.  Try and be honest with those around you- once I was honest with my colleagues at work, it was like  a weight lifted off my shoulders as I realised they weren't judging my every move. It is okay to have  bad days, and it is also okay to have good ones; having depression or anxiety makes you feel guilty  when you have a good day, but that is okay. Recovery isn't linear, and it will be up and down, but  don't lose hope because I promise one day you have everything you've dreamed of and can be so  proud of yourself. 

6: Dealing with a loss of structure 

I chose to study Pharmacy due to my genuine love for helping people. As a medicines counter  assistant and dispenser, I loved being able to use my knowledge to help people with something as  important as their health. It was great to be on the doorstep of peoples community, and the first  place that people of all ages could come for help. Being able to build a relationship with a patient  and knowing that you made a difference, even in a small way, was what led me to study to become a  Pharmacist.  

As a child, I was always called ‘bossy,’ (I like to think of it more like a natural leader!) which made the  countless opportunities within Pharmacy appealing; knowing that one day I could be a boss, and  inspire the next generation of bossy people after me. 

For me, one of the hardest parts of the COVID-19 pandemic has been adapting to seeing people  exclusively virtually, including my friends and family, and also my lecturers and peers. I miss being  able to go to a workshop and being able to work through a problem with a friend sat next to me using a whiteboard to draw crazily complicated chemistry mechanisms. Whilst online learning does  provide flexibility, I miss the structured routine- especially the fact that I knew that 9 AM starts in  person were non-negotiable. Online university can feel very isolating, especially for a people-person  like me. It can be really hard to get motivated, which makes me feel guilty as I compare myself to  how much work I could/should be getting done. 

There have been times when I have felt particularly low. Overwhelmed with the anxieties that  occupied my brain before these times, in addition to an intense university course that feels isolating  on top of what sometimes feels like a never-ending global pandemic. Exhausting. 

TIPS: Personally, on days that I feel totally lost and down, I try to escape from the real world for a  bit. Focusing on anything but my racing mind; through video games or getting lost in a good film or  music playlist. I am trying to learn to accept that there will be days that feel hard, where I mourn  about the university experience I’m missing, and where it does feel like COVID-19 is a losing battle,  but one day I will feel better than this.