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India’s big cities have a mental health problem
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India’s big cities have a mental health problem

Do urban folk face increasing mental health concerns than their rural peers, or are they just talking about it more?
A group of people walking on a busy crossing
Representational image | Unsplash

“I always feel less stressed when I just breathe clean air, eat healthy food and take a break from all the noise and chaos of the big city,” confesses Shriya S, a Bengaluru-based media professional.

As a person who suffers from anxiety and depression, Shriya says Bengaluru’s pollution levels, traffic-riddled roads, long hours of commuting and lack of greenery are only increasing her anxiety levels. “I think everyone in this rat race wants to prove something,” she says. Shriya voices what a lot of people in large cities experience. Metros top the list when it comes to mental health status in India.

A survey conducted by the National Institute of Mental health and Neurosciences (NIMHANS) in 2015-16 showed that at any given point in time, those living in urban metros were more prone to mental morbidities than those living in urban non-metros and rural areas.

For example, the prevalence of schizophrenia and other psychoses, mood disorders and neurotic or stress-related disorders was nearly two to three times more in urban metros. Similarly, an individual’s risk of suicide was highest among women and those living in urban metros, while mental disorders like schizophrenia, other non-affective psychoses and bipolar affective disorder were detected more among men and people in urban metro areas than in other comparable groups.

Complex lifestyles

The National Mental Health Survey (NMHS) lists several factors like fast-paced lifestyles, stress, complexities of living, breakdown of support systems, challenges of economic instability as some of the causes for this higher prevalence of mental illness in India.

Dr Mathew Varghese, former professor of psychiatry at NIMHANS, who was a principal investigator of the survey, says there are several socio-cultural reasons why people may be highly susceptible to mental issues in the urban metros. Migration (moving from rural, tier 1 or tier 2 cities to big cities,) staying away from home, not having any work or money during the Covid-19 pandemic could be some of the reasons, he says.

The mind-body link

Bengaluru-based clinical psychologist Shubha Madhusudhan of Manasvi Counselling Centre blames the mechanical lifestyles of those in the city work as stressors. “Most people in the city lead a sedentary lifestyle and have unhealthy routines due to which their bodies do not get enough exercise, which in turn affects their mental health problems in India,” says Madhusudhan.

Not just this, she feels that with the advent of technology, many relationships are formed in the virtual world, reducing the chances of making meaningful connections. “The proliferation and use of OTT content aids the sedentary lifestyle. Watching content that is quite different from reality can also lead to detachment,” she says.

Urban vs rural lifestyles

Indore-based Chetana Alex, a trained psychologist and a member of the British Psychological Society, is of the opinion that both urban and rural people deal with different kinds of stress. But how they deal with them is what makes all the difference.

“In rural areas, people are more in tune with nature and their human instincts. The lifestyle is such that it helps to relieve stress. However, in urban areas, the shift from the joint family to the nuclear family has reduced the scope for communication and sharing of emotions. Additionally, for those living in cities, there is a lot of pressure to live up to some pre-set ambitions,” she says.

But Alex also adds a caveat that heightened awareness about mental health issues in urban areas may lead to greater identification and reporting of cases, which explains higher numbers.

Effects of the pandemic

New-age crises like the COVID-19 pandemic, wars and human-made calamities tend to have the most impact on urban areas. “With the work-from-home [culture] due to the pandemic, I can no longer keep work away from my personal life. I often end up working late into the night and that has affected my health, my schedule and my sleep. I can’t seem to catch a break,” says Sagnik Sinha, an information technology professional in Bengaluru.

While many in urban areas find it difficult to maintain a healthy work-life balance due to the shift to the online mode of work, many even chose to go back to their hometown or go on ‘workcations’ (combining work with a vacation). “I think those who got the chance to work remotely during the pandemic enjoyed their time away from the city,” says Shriya.

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