Mental Disorder

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Mental Disorder

Sunday, 10 April 2022 | Biswajeet Banerjee

Mental Disorder

Heatwaves have been associated with mood disorders, anxiety disorders, dementia, and anxiety-related disorders among others. Extreme heat exposure can lead to physical as well as psychological exhaustion writes Biswajeet Banerjee

The Psychiatry Department of King George’s Medical University in Lucknow has witnessed a sudden spurt in cases of suicidal tendency, irritability, anxiety, and bipolar disorder in the last fortnight. Experts attribute l these cases of mental disorders to heatwave condition that is sweeping a large swathe of the country.

On March 28, Mahendra Verma, a medical representative, had a fight with his wife Anita. He even threatened to commit suicide. When he met a psychiatrist and complained about sudden mood swings ranging from aggression to depression, doctor diagnosed it as a seasonal affected disorder –caused by harsh summer which came early this year.

Incidentally, in India mental disorders caused by climate variations are not taken seriously. Studies have found that people with mental illness were three times more likely to run the risk of death from a heatwave than those without mental illness. Some evidence seems to hint at a  different vulnerability between genders. It claims that the percentage of deaths among women was higher than in men. Despite such a grave situation, people in India do not go to doctors for medical consultations.

Harsh March Heat

India is passing through a rough weather situation as it recorded the hottest March days in the last 121 years with the scorching summer arriving early this year. The India Meteorological Department (IMD) says Maximum temperatures recorded this March were 4.5 degrees above average in most regions of Himachal Pradesh, Haryana, Chandigarh, Delhi, Punjab, Uttar Pradesh, and Rajasthan.

“Heatwaves are spikes of high temperatures lasting some days that range outside the normal temperature for a specific season. This phenomenon is connected with climate change as they have increased in frequency and intensity,” said J P Gupta, the Met official.

In India, the maximum temperature peaks in April, and the month of May is considered the hottest. “This year is an exception when a heatwave was experienced in March. The southerly winds from Gujarat, south Pakistan took the heat to southern and southwest Rajasthan while due to lack of western disturbances, which brings colder winds, the temperature in Jammu, and its neighboring areas remained higher than normal,” said Gupta.

What further aggravated the situation was the lack of pre-monsoon showers. In March generally, there is significant thunderstorm activity and associated rainfall across India. This year there were 83 percent deficit rains across India.

Severe Heat is a mental issue too

American Psychiatric Association in its report titled Rs Extreme Heat Contributes to Worsening Mental Health, Especially Among Vulnerable Populations’ says that extreme heat has been associated with a range of mental health, including an increase in irritability and symptoms of depression and an increase in suicide. It can also affect behaviour, contributing to increased aggression, the incidence of domestic violence, and increased use of alcohol or other substances to cope with stress.

Dr. Adarsh Tripathi, Additional Professor, Department of Psychiatry, King George’s Medical University in Lucknow said that the seasonal affected disorder has a scientific pattern. but in India no one takes it seriously. There are scientific studies to show that everybody is not sensitive to weather variation. Only specific people get affected by it. And those who get affected should take care, he said.

“Physical health, mental health, human well-being, and heat waves appear to be specifically interconnected. Heat stress directly caused by heatwaves has been associated with mood disorders, anxiety, and related consequences,” Dr Tripathi said.

The experts vouch that heatwave is not only rise in temperature but it can trigger serious mental health issue such  as frayed tempers, an increase in anxiety, and bipolar disorders. “There is no structured study in India about the impact of heatwave,but some Western countries have carried out studies to show that mental health outcomes of climate change range from minimal stress and distress symptoms to clinical disorders, ranging from anxiety and sleep disturbances to depression, post-traumatic stress, and suicidal thoughts,” Dr S K Pandey, Medical Officer, Ram Manohar Lohia Institute of Medical Sciences in Lucknow said.

He said that Climate and Health Profile Report has identified the direct and indirect impact of extreme heat on health. It has been claimed that health risks caused by these factors have significantly risen in recent years.

Dr Pandey said that in India as people stay outside more during summer their exposure to the heat is very high. This could increase feelings of hostility and aggressive thoughts and possible actions. The increase in heat-related violence is greater in summers and, therefore, people could be seen saying Rs garmi dimaag mein chadh gayi’ – an indication of aggressive behavior. Hot summer temperatures lead to an increase in mental health emergencies, but unfortunately, these are not recorded in India, he said.

Dr. Samarjeet Srivastava, a private practitioner said there is a definite relation between temperature rise and aggressive behavior as an increase in crime rate and aggression has been observed during the hot summer months, suggesting a link between aggressive behavior and temperature. ”It has been seen that suicides, especially violent ones are more common with the recent increase in temperatures,” Dr Srivastava said.

In a study titled  Rs Mental health effects of climate change’ by Susanta Kumar Padhy, Sidharth Sarkar, Mahima Panigrahi, and Surender Paul say heat waves have been associated with mental and behavioral disorders. It further cites a study from Australia  that heat waves are associated with increased rates of admissions for mental disorders also, in conjunction with other disorders such as cardiovascular and renal illness.

“Such heat waves have been associated with mood disorders, anxiety disorders, dementia, and anxiety-related disorders among others. Extreme heat exposure can lead to physical as well as psychological exhaustion,” the study said.

It also quoted another  study from Thailand suggesting that occupational heat stress is associated with greater psychological distress among workers. “Similar other studies have found an association between increased temperatures in the workplace and greater psychological distress,” the writers said.

“Unfortunate part is India being a hot tropical nation where the temperature hovers over 45 Degree Celsius at many places no one takes mental health issues caused by severe heat as a serious health issue. For us, this is just another illness that will pass with the passage of time. This does not happen. There are thousands of people who do not come to hospitals or consult doctors to treat their disease because they do not know that they are ill caused by severe weather,” Dr. Pandey said.

Increase in street brawls

The police claim that street brawls increase by over 18 percent during summer as compared to winter. But the number of street brawls in Lucknow increased by 46 percent in March 2022 as compared to 2021. The police dossiers show that in March 2021, 128 cases of street brawls were reported while it rose to 187 in March 2022.

The police do not have a justification for this increase in cases. These brawls are generally between the hawkers. They start as a non-issue and result in fisticuffs. “These hawkers stand under the sun for very long in summer and probably because of scorching heat they become irritated and at a drop of a hat they pick up a fight,” Narendra Nath Srivastava, a police officer said.

But police do not treat these brawls as a case of mental disorders. “I do not think these people need any medical consultation. These people once give vent to their anger, they cool down. People are generally irritated in summer and it is natural,” Srivastava said.

The writer is the Political editor of The Pioneer (Lucknow)

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