Amid New Delhi’s choking smog, doctors are alert for signs of mental distress caused by pollution

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Jay Dhar looks out the window of his home in New Delhi and sees the thick smog that has engulfed the city. He suffers from severe allergies and asthma, and pollution makes it difficult for him to breathe. It also leaves him feeling depressed.

“The whole city has suddenly changed. It looks like a ghost town,” the 52-year-old said.

When temperatures began to drop in mid-November, the air quality index in the Indian capital moved to the severe category. According to the World Health Organization, an air quality index (AQI) over 300 is considered dangerous. In the two weeks beginning November 13, in New Delhi The average air quality index (AQI) was 492.

Ranked as one of the most polluted cities in the world, New Delhi’s population of 20 million has seen increases in respiratory illnesses and other problems such as allergic rhinitis, headaches and skin problems.

Experts say the impact of air pollution on mental health is now a cause for concern.

A man holds the black square filter from an air purifier.
Dhar stands with a black filter from one of his home’s air purifiers. (Vijay Pandey)

Dhar, who describes himself as a “victim of air pollution”, said he constantly has to use a nebulizer – a small machine that delivers medicine in a spray – which raises his health concerns and affects his daily life.

Winter, with deteriorating air quality, leaves him feeling depressed and helpless and he doesn’t even enjoy the Hindu festival of Diwali anymore. The celebration often takes place just before temperatures drop Explosion of firecrackers Contributes to deteriorating air quality.

“Air pollution makes everything worse.”

Physical and mental health are treated in the new clinic

At the city’s Ram Manohar Lohia Hospital, a pollution clinic — the first of its kind in Delhi — was opened in October 2023. In addition to doctors who deal with respiratory, skin and eye problems, the clinic also includes psychiatrists, a decision sparked by mounting evidence linking air pollution to mental health. .

“The idea was to bring all the professionals involved, including mental health, under one roof and make it easier for patients to seek help,” said Dr Amit Suri, head of the clinic.

On December 5, Delhi was allowed to relax Strict emergency restrictions imposed on November 18 to tackle rising air pollution. Some of the Phase 4 measures of the Graded Response Action Plan (GRAP) included closing schools and colleges and halting non-essential construction.

Woman and man sitting at a desk. She fills out paperwork and talks to the man in the face mask.
A health worker at the pollution clinic at Ram Manohar Lohai Hospital, left, talks with a patient who came to the clinic on November 25 due to coughing and breathing problems. (Vijay Pandey)

Priyanka, the clinic’s chief resident psychiatrist, who uses only her first name, says mental health issues mostly affect children and the elderly, but she said all ages can experience mental health changes as a result of their physiological reactions to pollution.

She said fine particles in the air, often called PM2.5, can cross the blood-brain barrier, causing inflammation and changing the chemical reaction of the brain. PM2.5 refers to particles less than 2.5 microns in diameter. A human hair is about 75 microns wide.

In children, pollution is linked to poor neurodevelopment. Impact on abilities such as memory, learning and speaking. She said they can feel dizzy and sad and may have difficulties adjusting to their studies.

In the elderly, pollution It affects their cognitive declineShe said this leads to forgetfulness and loneliness.

Priyanka said there is a lack of awareness about mental health issues in India, as well as a social stigma that prevents people from seeking professional help.

“People who are already facing mental health issues are more vulnerable to contamination,” she added. “This can exacerbate stress and anxiety and can lead to depression.”

New search

Uttara Balakrishnan is a senior research economist at the Virginia-based American Institute for Research, whose work often addresses specific situations in developing countries.

In 2021, Balakrishnan was the lead author of A He studies On the impact of air pollution on mental health in India. It found that exposure to air pollution in a given calendar year led to significantly worse mental health the following year.

“It was an understudied topic, and we wanted to fill in the causality, not just the association, between air pollution and mental health,” said Balakrishnan, who completed part of her studies at Delhi University.

A truck drives through thick smog along an almost empty street. Two people stand near him on the sidewalk.
A government vehicle in Delhi sprays water to control air pollution on November 18. (Manish Swarup/The Associated Press)

Balakrishnan said the team’s approach looked at variables that could affect exposure to air pollution, such as where people live, their working conditions, and their physical health.

“Mental health is also linked to poverty and income,” she said. “Any developing country – such as India, Pakistan and Bangladesh – will have high levels of mental health problems because poor mental health leads to decreased labor force participation and increased health care utilization and can perpetuate poverty.”

In 2023, Cambridge University Press Published a review It evaluates current research on air pollution and mental health, and suggests some priorities for future studies.

“When it comes to the link between mental health and air pollution, the scope of these studies is limited,” said Dr. Pallavi Rajhans, a Delhi-based psychiatrist who was not involved in the review. “With air pollution becoming a major concern, more research should be conducted in this area.”

Mental health concerns have also been identified in the Delhi government a report About air pollution that was submitted in April to the National Green Tribunal, India’s environmental tribunal. According to news reports, the government advised taking measures such as being active or talking to a therapist to combat feelings of sadness, cognitive difficulties, and a decreased ability to cope with life’s challenges.

“I don’t know what the future looks like”

A woman crouches next to two children sitting on small chairs on a high-rise balcony. Behind the transparent balcony barrier, the dense smog nearly obliterates the city skyline.
Aparna Agarwal, with her children Avni and Aveer, looks at the smog-covered city from the balcony of her home in Delhi on November 25. (Vijay Pandey)

Aparna Aggarwal feels terrible about the situation in the city.

For weeks, her two children, Avni, 6, and Aveer, 4, had difficulty breathing and needed to use a nebulizer every day. They were irritable due to aggressive behavior and mood swings.

She feels “helpless and disturbed.”

Before schools closed in mid-November due to GRAP 4 restrictions, her son’s teacher told her that Aver complained of being sad and unhappy but didn’t know why.

She said the deteriorating air quality meant they could not go out to the balcony or to the garden. “They were complaining of constant headaches. Most of the time they are inside, and they feel restricted.”

After weeks of virtual classes, missing their friends, and limited outdoor activity, air quality has improved and many restrictions have been lifted. This is a “temporary relief,” Agarwal said.

“And seeing air pollution slowly killing my children, I don’t know what the future looks like.”



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