Jai Dhar looks through the window of his house in New Delhi and sees the thick smog that has engulfed the city. With severe allergies and asthma, the pollution makes it difficult to breathe. It also makes him feel gloomy.
“The whole town has suddenly changed. It's like a ghost town,” said the 52-year-old.
When temperatures began to drop in mid-November, the air quality index (AQI) in India's capital moved into the severe category. According to the World Health Organization, an AQI above 300 is considered dangerous. In the two weeks starting November 13, New Delhi's The highest value of the AQI category was 492.
Considered one of the most polluted cities in the world, the 20 million residents of New Delhi have seen an increase in respiratory ailments and other issues such as allergic rhinitis, headaches and skin issues.
Now the impact of air pollution on mental health is also emerging as a cause for concern, experts say.
Describing himself as an “air pollution victim,” Dhar said he constantly has to use a nebulizer – a small device that delivers medicine in a mist – which causes his health to suffer and affects his everyday life.
Winter, with its worsening air quality, makes him feel depressed and helpless and he doesn't even enjoy the Hindu festival of Diwali anymore. The celebration often happens just before the temperature drops and the firemen's break contributing to the deterioration of air quality.
“Air pollution makes everything worse. “
Physical, mental health treated at new clinic
At the city's Ram Manohar Lohia Hospital, a pollution clinic – the first of its kind in Delhi – opened in October 2023. Apart from doctors dealing with respiratory, skin and eye problems, there are psychiatrists at the clinic as well, a decision encouraged by growing evidence. linking air pollution to mental health.
“The idea was to bring all the concerned specialists, including mental health, under one roof and make it easy for patients to seek help,” said Dr Amit Suri, head of the clinic.
On December 5, Delhi was allowed to relax the strict emergency restrictions imposed on November 18 to deal with rising air pollution. Some of the Phase 4 measures of the Phased Response Action Plan (GRAP) included closing schools and colleges and stopping non-essential construction.
The clinic's senior resident psychiatrist, Priyanka, who will go by her first name only, says mental health issues mostly affect children and the elderly but she said everyone can age to experience changes in mental well-being as a result of the physiological reactions to pollution.
Fine particulate matter in the air, commonly known as PM2.5, can cross the blood-brain barrier causing inflammation, and altering the brain's chemical response, she said. PM2.5 refers to particulate matter less than 2.5 microns in diameter. The width of a human hair is about 75 microns.
In children, pollution is linked to impaired neurodevelopmental growth, affecting abilities such as memory, learning and speaking. They can be left feeling dizzy and sad and may have problems dealing with their studies, she said.
In the old people, pollution affect their cognitive declinewhich causes forgetfulness and isolation, she said.
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.
“The people who already have mental health problems are more vulnerable to pollution,” she said. “It can make the stress and anxiety worse and it can cause depression.”
New research
Uttara Balakrishnan is a senior research economist at the Virginia-based American Institute for Research whose work often looks at specific situations in developing countries.
In 2021, Balakrishnan was the lead author of a study on the mental health effects of air pollution in India. He found that air pollution in a particular calendar year resulted in significantly worse mental health the following year.
“It was an understudied topic, and we wanted to fill in the causal link, not just a correlation, between air pollution and mental health,” said Balakrishnan, who did part of her schooling at University of Delhi.
Balakrishnan said the team's approach looked at variables that could affect air pollution exposure, such as where people live, their work conditions, and their physical health.
“Mental health is also related to poverty and income,” she said. “Any developing country – like India, Pakistan and Bangladesh – would have high rates of mental health issues because poor mental health leads to lower labor force participation and higher health care utilization and may perpetuate poverty.”
In 2023, Cambridge University Press publish a review which evaluated existing research on air pollution and mental health, and suggested some priorities for future studies.
“When it comes to the correlation between mental health and air pollution, the scope of these studies is limited,” said Dr Pallavi Rajhans, a Delhi-based psychiatrist who was not part of the study. of great concern, more research should be done in this area.”
Mental health concerns have also been identified in the Delhi government report on air pollution submitted in April to the National Green Tribunal, India's environment court. According to news reports, the government advised measures such as being active or talking to a therapist to combat sad feelings, cognitive problems and a reduced ability to deal with life's challenges.
'I don't know what the future will look like'
Aparna Aggarwal is disappointed about the state of the city.
For weeks, her two children, six-year-old Avni and Avir, 4, had trouble breathing and had to use the nebulizer every day. They have been irritated by aggressive behavior and mood swings.
She feels “helpless and confused.”
Before schools were closed in mid-November with GRAP 4 restrictions, her son's teacher told her that Avir had complained that he was sad and unhappy but she didn't know why.
Air quality was going down which meant they couldn't go out on the balcony or to the park, she said. “They've been complaining of constant headaches. Most of the time they're indoors, and they feel confined.”
After weeks of virtual classes, missing friends and some outdoor activities, the air quality has improved and many restrictions have been lifted. But it is a “temporary relief,” Aggarwal said.
“Watching this air pollution slowly kill my children, I don't know what the future will look like.”
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