Depressive symptoms may be the observable features of several different mental conditions, which require different treatments. It is particularly important to identify bipolar vulnerability. Alcohol and other recreational drugs can cause or worsen depression and anxiety. Eating disorders can be manifestations of depression or anxiety, but can also bring about these conditions. People with autism may be particularly vulnerable to anxiety disorders. Students suffer from depression and anxiety disorders at around the same rate as the rest of their age group but have unique difficulties accessing treatment. They can benefit from access to psychotherapies alongside medication to enhance benefits. There is a wide range of anxiety disorders, and anxiety is very often present alongside depression. In such cases higher doses of the so-called ‘antidepressant’ drugs are required. Students and staff may have both genetic and environment predispositions to mental disorders. Treatments which have helped a family member may prove most effective. Prescribing for female students and staff should consider safety during any future pregnancy. Students with more severe depression or anxiety disorders require longer therapies than university counselling routinely offers. Discussions with local NHS clinics are needed. Arrangements for treatment during vacations are essential.