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Times Of India
16 july 2012

Ahmedabad: When the people in West feel sad and depressed, they see a doctor and declare that they are unhappy. While locally, majority of them say that they are suffering from acute headaches, body and chest pain, nausea and fainting spells!

A thesis by Dr Vimal Somaiya of psychiatry department of the VS Hospital, under the guidance of Dr Laxman Dutt, underlines that there is a severe lack of awareness about mental ailments.

A study was conducted on 120 patients who visited the VS Hospital. Of these, 60 patients consulted the psychiatric OPD while the remaining consulted medical OPD. These included men and women from different age groups.

The study found that over 30 per cent of the people who consulted general medicine doctors had underlying symptoms of mental disorders including general anxiety, panic and depression.

Amongst the psychiatric patients, over 60 per cent primarily resorted to complaining of physical symptoms like nausea, headache, chest pain in cases of clinical depression and other mental ailments.

Doctors say this shows lack of awareness concerning mental ailments. Plus, there is a huge section of masses that live in denial when it comes to dealing with mental problems.

Rekha Patel, a 46–year–old housewife is one such case. She had been frequently visiting a general physician complaining of headache since three months. The headaches lasted throughout the day leaving her head heavy, disturbing her in daily routine of household work. She also complained of severe fatigue, weakness and lethargy without any apparent reason.

"She got her blood tested as well as MRI reports done but all tests were normal. She had received lengthy treatment of analgesics and anti–migraine medicine without any improvement. Detailed interview of the lady revealed that her husband had died in a road accident and she suffered loneliness and increased irritability over trivial matter. The diagnosis was simple — she suffered from masked depression and required medication as well as psychotherapy," says Dr Vimal. Interestingly, when advised to consult psychiatrist, she shouted, "I do not need a psychiatrist. I am not mental."

Similarly, Rahim Abdullah, a 48–year–old businessman from the walled city suffered from severe indigestion which was diagnosed as irritable bowel syndrome. "He would refrain from eating anything from outside and became acutely aware of what he put in his mouth. Yet he had an upset stomach. We finally diagnosed that there was an underlying psycho–logical pathology and put him on drugs which effectively treated his chronic gastric troubles", said Dr Laxman Dutt.

What is psychosomatic illness
Psychosomatic is derived from Greek words psyche (soul) and soma (body). The term literally refers to how the mind affects the body. Unfortunately, this is commonly used to describe an individual with medical complains that have no physical cause by dismissing it saying, "It’s all in your head."

It might be all in the mind
The neurobiological basis of anxiety disorders and depressive disorders points to the involvement of dysfunctional serotonergic, non–adrenergic or dopaminergic neuronal circuits. If the physician realizes that the same dysfunctional circuits can produce ‘real’ physical symptoms and they are legitimate manifestation of disorders which are primarily emotional, it will help physicians treat patients better!

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