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Psychosomatic disorders in India

Five to ten percent of Indians seeking treatment for neurological conditions suffer from psychosomatic disorders, According to an article recently published in The Quint,. These disorders come with no clear physical or physiological cause, says the article, but are related to stress and anxiety.

The body under normal conditions, with no physical ailments, maintains a homeostatic balance. This is the process by which the body maintains a constant biochemical equilibrium ensuring consistency in matters such as body temperature and energy levels. Psychosomatic conditions arise because emotional responses, including stress, cause  biochemical changes.

Primarily associated with stress response is cortisol, the “stress hormone”. Consistent stress is linked to massive fluctuations of cortisol levels — mostly excess production.  This upsets  the body’s homeostatic balance through an increase in adrenaline. Consequently, high levels of adrenaline for prolonged periods of time result in adrenal fatigue.

The symptoms associated with adrenal fatigue match those stated in The Quint’s article. In their discussion with Dr Manjari Tripathi, Professor of Neurobiology at AIIMS. She says that  common symptoms are unexplained limb pain, fatigue and headaches. All of these can be attributed to adrenal fatigue.

A primary issue with illnesses such as this is misdiagnosis so Dr Tripathi suggests that extensive examination by a physician is required. All possibilities must first be ruled out to avoid leaving a physical condition untreated, only then is it appropriate to send the patient to a psychiatrist. Under this process any physical ailments can be addressed if needed before turning attention to the cause of a psychosomatic condition, stress typically playing a key role.

This view is not a new line of thought. It has been common clinical practise and documented as far back as 1964. The logic being that if the underlying psychological issue is addressed, the physical symptoms will alleviate themselves.

In India however, this extensive medical investigation may not be an option for many. Dr Tripathi mentions in the article that: “Psychosomatic disorders are very, very prevalent in India. Every household will have at least one member with this condition”. It is a condition that, due to the inadequate infrastructure in regards to mental health treatment in India will likely go undiagnosed and untreated.

For many such an in-depth medical overview, likely involving numerous consultations with a doctor will be financially impossible. While India predominantly relies on private health care the poor will not be provided with adequate treatment.

In the case of psychosomatic illness, repression of the condition, whether voluntary or through inability to make any positive changes towards treating it, can worsen the disease. For some it will simply be ignored due to a lack of knowledge of the illness. Without a large scale shake up of India’s mental health treatment and an emphasis on public information and education to bring it to people’s attention, the issue will likely worsen.

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