Everyday mental health challenges often show up as stress, anxiety, depression, and burnout, which affect work, relationships, and even physical health. These issues are widespread globally, often hidden due to stigma, but they impact productivity, interpersonal relationships, and overall well-being. Substance Use Disorders (SUDs) have been discussed in my article on addiction on October 12, 2025. Personality disorders were discussed in my article on May 11, 2025.
STRESS & BURNOUT
Constant stress for students and at work, due to intense competition, long hours of work, constant deadlines, night shifts, loneliness, lack of community support, job insecurity, and financial worries, causes fatigue, irritability, and poor focus, leading to burnout and health risks. Burnout manifests as exhaustion, cynicism, reduced productivity, and harms career growth. This has been discussed in my articles ‘Take a break, avoid a breakdown’ on April 27, 2025, and ‘Dozing on the job across time zones or on long shifts can be deadly’ on August 3, 2025.
ANXIETY DISORDERS
Anxiety disorders involve excessive, persistent, and overwhelming fear or dread before an event, avoiding interactions with others that interfere with daily life, severe self-criticism or analysis after a social situation, and even panic attacks. Symptoms may be sweating, trembling, a shaky voice, or rapid heartbeat.
•Generalized Anxiety Disorder is a persistent and excessive worry about everyday events, such as finances, health, or chores, that is difficult to control. It leads to restlessness, fatigue, muscle tension, and difficulty concentrating.
•Panic Disorder is characterized by sudden, repeated, and unexpected panic attacks. Intense surges of fear accompanied by physical symptoms like heart palpitations, chest pain, shortness of breath, and feelings of impending doom can be mistaken for a heart attack. Never leave the person alone till the peak passes, usually in 10 to 20 minutes.
•Social anxiety is an intense, persistent fear of being watched, judged, embarrassed, or humiliated in social or performance situations. It causes avoidance of everyday interactions, entirely because of fear of rejection or negative evaluation. Common triggers are meeting new people or talking to strangers, having to answer questions or speak up in meetings, attending parties or large social gatherings, eating or drinking in front of others, making phone calls or interacting with colleagues and seniors.
•Fear psychosis is a state of widespread, irrational terror or anxiety within a group, community, or society. It occurs when collective panic and severe worry overshadow rational thinking, often causing people to alter their daily behaviours and make irrational decisions, including violent protests and rioting, based on perceived threats or misinformation.
•Specific phobias are an irrational, intense fear of specific objects or situations (e.g., heights, spiders, flying, or needles) that trigger extreme, immediate anxiety and avoidance. Agoraphobia is an intense fear of becoming overwhelmed or trapped in enclosed, unfamiliar, or public spaces or crowds, making a person fear leaving home alone.
•Separation Anxiety Disorder is an extreme and developmentally inappropriate fear of harm coming to or being separated (lost or kidnapped, etc.) from individuals with whom the person has a deep emotional bond.
•Selective Mutism is a condition primarily affecting children where they consistently fail to speak in specific social situations, like in school, despite being able to speak comfortably at home.
MANAGEMENT
Anxiety disorders are manageable through a combination of professional therapy, lifestyle adjustments, and sometimes antidepressants or anxiolytics.
•Professional treatment is mainly by Cognitive Behavioural Therapy (CBT) to help identify, understand, and change negative thought patterns, behaviours, and irrational fears that trigger anxiety. Exposure therapy is a specific type of CBT used primarily for phobias and social anxiety. It involves gradual, controlled exposure to the feared object or situation to reduce sensitivity over time.
•Grounding techniques are somatic and cognitive exercises designed to disrupt a panic attack.
•Lifestyle adjustments and self-care strategies include regular exercise and physical activity, deep breathing exercises, meditation, and progressive muscle relaxation, prioritizing 7–9 hours of undisturbed sleep and limiting caffeine, alcohol and screen time, joining support groups or talking openly with trusted friends and family to reduce isolation. Sleep disorders, including insomnia, have been discussed in my article ‘Sleep well to stay healthy’ on April 20, 2025.
DEPRESSIVE DISORDERS
Depressive disorders are a group of mental health conditions characterized by persistent sadness, fatigue, a loss of interest in daily activities, and emotional or physical impairment. They undermine how a person thinks, feels, and handles basic daily responsibilities like cooking, hygiene, or managing finances. They lead to withdrawal from social connections, irritability, and sleep disruption. The American Psychiatric Association outlines several distinct forms of depressive disorders:
•Major Depressive Disorder (MDD): Characterized by a pervading dark mood, feelings of worthlessness, and an inability to feel pleasure (anhedonia) that lasts for at least two weeks.
•Persistent Depressive Disorder (Dysthymia): A chronic, long-term form of depression where low mood persists for most of the day, on many days, for at least two years.
•Peripartum Depression (Postpartum/Prenatal): Major depressive episodes that begin during pregnancy or within the weeks following childbirth.
•Seasonal Affective Disorder (SAD): Depression cycles linked directly to seasonal shifts, typically manifesting in late autumn and winter months.
•Premenstrual Dysphoric Disorder (PMDD): A severe form of premenstrual syndrome marked by intense irritability, anxiety, and deep depression in the week before menstruation begins.
•Disruptive Mood Dysregulation Disorder (DMDD): Diagnosed in children and adolescents, involving frequent, severe temper outbursts and persistent underlying irritability.
MANAGEMENT
•Lifestyle adjustments and self-care measures cannot
•Clinical management includes CBT to identify and reshape negative thought patterns and behavioural habits that reinforce the depression; Interpersonal Psychotherapy (IPT), a time-limited therapy addressing personal relationships, communication issues, and life transitions contributing to the depressive state; and antidepressants. For severe, life-threatening or suicidal, or treatment-resistant depression, clinicians may utilize Electroconvulsive Therapy (ECT) or Transcranial Magnetic Stimulation (rTMS) to safely stimulate mood-regulating brain pathways.
MENTAL HEALTH PHYSICAL HEALTH LINKS
•Chronic stress raises cortisol, harming heart health and immunity.
•Sleep disruption worsens risks of diabetes, obesity, and chronic pain.
•Depression is linked to higher rates of cardiovascular disease.
•Endocrine, cardiovascular, respiratory, neurological, autoimmune, and inflammatory disorders, nutritional deficiencies, and any major illness can cause anxiety and depression.
•Diagnostic tests for thyroid and parathyroid function, Anaemia, nutritional deficiencies, systemic inflammation, and diabetes are important for mental symptoms like anxiety, lethargy, low mood, brain fog, etc.
•Many prescription and over-the-counter medications
It is the psychological act of systematically devaluing your own worth and achievements in your mind. It is an active behavioural and cognitive process that maintains the deeply interconnected insecurity, self-doubt, and low self-esteem.
•Insecurity (the core problem) is the feeling of inadequacy or uncertainty about your value, skills, or appearance; self-doubt (the filter) is the inner critic that questions your abilities; and low self-esteem (the result) is the negative judgment of your worth. Together, they create a vicious negative cycle of self-talk that you are not “good enough”, dismantling your successes as mere luck, while magnifying your flaws, aggressively comparing your internal struggles against everyone else’s polished external highlights.
•By convincing everyone and yourself that you are incapable, you reduce the hurt of rejection and eliminate the terrifying parental, social, and career pressure to succeed or maintain a high standard.
•To break this cycle, you have to actively train your brain to react differently to your thoughts and triggers. Doubt your doubts, recognize your triggers, adjust your internal self-talk, accept your thoughts instead of fighting them, and let them pass without letting them dictate your actions. If these feelings are overwhelming, speak with a mental health professional who can provide personalized cognitive strategies to help you rebuild your confidence.
STIGMA & SILENCE
•Fear of judgment prevents people from seeking help.
•Cultural beliefs discourage open conversations about emotions.
•Only 10–15% of Indians needing care actually receive it, leaving millions untreated.
COUNSELLOR / PSYCHOTHERAPIST /PSYCHOLOGIST / PSYCHIATRIST
These mental health professionals differ significantly in their medical training, treatment approaches, and areas of focus.
•Counsellors (or therapists) focus on problem-solving, coping skills and strategies, and helping clients navigate specific, short-term life challenges or transitions such as grief, relationship issues, and career changes.
•Psychotherapists are a broad group of professionals who help clients uncover the root causes of emotional issues and develop strategies to modify behaviours and thought patterns.
•Psychologists focus on comprehensive mental health evaluations, psychological testing (like IQ or personality testing), in-depth diagnosis, and long-term psychotherapy, such as CBT.
•Psychiatrists are specialized psychiatric doctors who treat severe or complex mental illnesses (e.g., schizophrenia, severe bipolar disorder, clinical depression) where laboratory tests, brain imaging, and medication are necessary. Mental health challenges are everyday realities, not rare events. They affect work performance, relationships, and physical health simultaneously. Early recognition and open conversations are crucial to break the stigma. Practical steps include mindfulness, exercise, social connection, and professional help when needed.
Dr. P.S. Venkatesh Rao is a Consultant Surgeon, Former Faculty at CMC (Vellore), AIIMS (New Delhi), and a polymath in Bengaluru, drpsvrao.com
