This mental health crisis is clawing away at one in every seven Indians, says a recent study. But experts believe those numbers fall way below reality
Three years ago, Tarun Arora woke up one night gasping for breath, incoherent and nauseous. He knew exactly what had brought on the panic attack — having suffered similar symptoms seven years earlier. “In the morning I could not make myself go to work,” says Arora, 44, who is originally from Bhatinda but now lives in Mumbai. “I lied to my boss and stayed in bed for the next two days. But after two days I had to tell him the truth. Since then, I have been on medication, engaging in cognitive behavioural therapy and running every morning. I spoke to my family, friends and a few colleagues, including my boss, about this. I can say I am on the path to recovery,” he adds.
Arora is like one of every seven Indians suffering from some sort of mental health problem, according to a study conducted by the Indian Council of Medical Research (ICMR) that was published in December by Lancet, the celebrated medical journal. Arora has anxiety which, along with depression, tops the charts of mental health issues flagged by the ICMR study. The study also finds that in Maharashtra, out of one lakh people, some 3,400 to 3,959 suffer from anxiety, and the state ranks sixth on this ignominious tally, after Kerala, Karnataka, Telengana, Tamil Nadu and Himachal Pradesh. Indeed, prevalence of both depressive disorders and anxiety were reported to be higher in the southern states than those in the north, the study finds.
Do the numbers lie?
A number of Mumbai-based psychiatrists and psychologists have pointed out that the ICMR study has grossly underestimated the number of people suffering from anxiety. This comes as no surprise, given a lack of understanding about, and inability to recognise, mental illnesses, as well as the taboo attached to them. Even the researchers have admitted in the report that the burden of mental disorders is likely to be “underestimated” for a paucity of data.
Anxiety is a natural emotion that every person feels, whether before a job interview, on the day of the wedding, or during a Barcelona-Real Madrid match.
“But when it interferes with their day-to-day functioning, it becomes a disorder,” says psychiatrist Hozefa A Bhinderwala. “I feel that about 30 per cent of the population has some sort of anxiety disorder and needs medical attention, but only a tiny percentage actually reaches out for help.” Anxiety disorders cover a wide spectrum, from panic attacks, social anxiety and general anxiety, to phobias. The symptoms also vary, from panic, fear, uneasiness, disturbed sleep, inability to sit calmly to sweaty and numb feet, shortness of breath, palpitation, dry mouth, tense muscles, chest pain and dizziness, or a combination of these. In many cases, it also feels like a daily struggle, a sort of war with oneself, or a feeling of being trapped and exhausted, where even the smallest task requires a lot of effort.
Clinical psychologist Sonali Gupta, author of the forthcoming book Anxiety: Overcoming it To Live Without Fear, says that the number of people seeking help to overcome anxiety has increased in the last six years. “Out of 30 patients who come seeking help, 20 or 25 would seek treatment for anxiety, which is largely invisible,” Gupta says. “There is no pause button on anxiety. If you maintain an outward calm, no one will even be able to recognise the turmoil going on inside. The most shocking part is that anxiety affects everyone, regardless of age or gender.” Gupta attributes the spike in the number of patients to the times we are living in, of “heightened uncertainty”, among other things. She explains: “There is heightened uncertainty everywhere. The socio-economic and political conditions are such that people feel they have less control over their lives today than they did some years ago. They worry about losing their jobs and may even over-think the situation. Sometimes even a cab driver cancelling a ride could spark anxiety.”
Indeed, the triggers can be many and varied. An advertising professional recounts how his attempts to avoid alcohol — which caused depression and anxiety — at social events aggravated his condition. “One day I decided to give up drinking,” he says. “But at office parties, or when out with friends, I was inevitably (and incessantly) asked why I wasn’t drinking. It became such a pain that I started avoiding these events.” Most people suffering from anxiety tend to put up a façade of normalcy to make life easier, both for themselves and others. But the outcome is usually the opposite: The pressure to ‘appear’ normal can itself cause anxiety.
A Chembur-resident working in a technical institute says that in his previous workplace, his anxiety attacks were triggered by situations where he was forced to do something. “Once my condition was known to my bosses, they avoided giving me any tasks. For days I would sit at my desk with no work,” he says. “Those hours of sitting idle while others went about their work, made me even more fearful about my future at the company, and worsened my condition.” In May 2017 Nikhil Taneja, writer-producerturned-mental health advocate and CEO of Yuvaa, a content creation company, found himself in the emergency ward of a Mumbai hospital with chest pain. “I was diagnosed with clinical anxiety, something that I did not know about. I thought the chest pain indicated a cardiac problem. But it was a panic attack,” says Taneja. “I was in a good place, both professionally and personally, so I couldn’t understand what was happening to me.” It took 18 months of therapy for Taneja to understand that he had unwittingly been affected by the pressures of a competitive worklife and living in a metropolis. When he posted about this on social media, Taneja was surprised at the number of people this resonated with. “I realise now that we are going through a mental health crisis,” he says.
But trying to make others — particularly family and friends — understand what one is going through, comes with its own challenges. “Even among those close to us very few actually try to understand what the problem is,” says a 33-year old corporate lawyer. Gender stereotypes come into play, he says, meaning that some mental health disorders are (erroneously) assumed to affect more women than men. “There are very few male friends I can discuss my anxiety with. Whenever I try, they respond with a studied silence. That leads to further alienation and aggravates the situation,” adds the lawyer, who has been dealing with anxiety disorders for two years.
Fighting your other self
There is no one formula that people resort to when dealing with panic attacks. “Once I painted the living room to take my mind off things that were causing me anxiety,” says the corporate lawyer. With his mind focused on the job at hand, the corporate lawyer could gradually overcome the day’s anxiety. A sociologist, who works with underprivileged children and was diagnosed with mental health issues, says getting a pet helped her deal with her situation. “While going through the rounds of check-ups, blood tests and medicines, I had shut myself up indoors and did not want to meet anyone,” she says. “Then I got myself a dog and now, when I take him out for a walk every day, I interact with other dogowners. I have even been able to build up a network.”
Sometimes when a person is diagnosed with a physical health problem, especially a critical one, the mental aspects often get sidelined. “Those who are undergoing treatment for some disease also suffer from degrees of anxiety. This is often left unaddressed,” says Dr Bhinderwala. Adds psychiatrist Nazneen Ladak: “A sense of comfort is very important for a person suffering from anxiety disorders. Every person goes through a degree of anxiety, but whether s/he has crossed the tolerance threshold into a disorder, can only be identified by counselling.” Only then can you, like Tarun Arora, find your path to recovery.
courtesy Mumbai Mirror