Times of India
11 October 2010
Mumbai, India

As Sunday marked World Mental Health Day, doctors in the city cautioned Mumbaikars to watch out for those tell–tale signs triggered by minor illnesses. You may have wondered how a small bout of fever can cause extreme sadness, or why even the slightest noise can jar your nerves when you have a cold or a headache. Doctors have the answer–physical illness can lead to psychological problems in patients.

Doctors across specializations say that patients suffering from an illness, especially chronic, tend to develop not just minor mental problems like distress and anxiety, but also major ones like depression, phobias and even sexual dysfunction. About 14–20% of chronically ill patients have psychological problems, apart from minor distress and anxiety, say doctors.

Dr Ganesh Kumar, head of cardiology at L H Hiranandani Hospital, says that at least one in three patients is suffers from mental problems, including anxiety. "Patients suffering from a heart failure or an attack, especially younger ones, develop severe mental problems. First of all, the patients do not want to accept the fact that they are chronically ill. And when they do, they directly start fearing death," he said. "Many young patients also start believing that having sex will stress out on their heart, which might lead to another attack. This causes sexual dysfunction and frustration in the patient as well as the spouse," he added.

Dr Ashok Mahasur, chest physician with Hinduja Hospital, says that respiratory problems tend to make patients even more psychologically conscious. "Problems like chronic obstructive pulmonary disease, drug–resistant TB and lung fibrosis can are the ones which cause a lot of distress in the patient. As these are long–term problems, the patient’s thinking gets negative," he said, adding that mental problems are rampant in 60–70% of patients suffering from respiratory illnesses. "Only around 20% of people–those who are not well educated or those who do not know much about the disease–have little anxiety," Dr Mahasur added.

It is not just those suffering from cardio or respiratory problems who get worried, but also those with chronic kidney ailments. "Patients suffering from end–stage kidney disease who cannot find a donor, especially those who have to go for dialysis regularly, undergo great trauma. They cannot carry out their regular functions, feel unproductive and believe that they are a burden on the family. Most of the time, affordability of the treatment is also becomes a problem," said Dr Bharat Shah, nephrologist, Lilavati Hospital.

Psychiatrist Dr Harish Shetty, however believes that depression in the chronically ill is generally misunderstood as anxiety. "If a person is suffering from diabetes and goes into depression, the family thinks it is because of erratic sugar levels. If symptoms of mental problems are taken care of along with the treatment for the physical illness, patients tend to recover sooner," he said.