If you think air pollution leads to a passing cough, cold and breathing difficulties, think again. Beyond its visible impact on physical health, air pollution has emerged as a silent accomplice to a growing invisible crisis: the deterioration of mental health. A research study by US and Denmark-based authors points to neuroinflammatory mechanisms linking air pollution and psychiatric problems — including depression, schizophrenia, bipolar disease, and personality disorder. This worrisome finding comes at a time when India’s 1.3 billion people live in areas where the annual average particulate pollution level exceeds the WHO guideline. Earlier this month, Delhi, Muzaffarnagar, Ghaziabad, Patna, and Mumbai were under the invisible toxic blanket of hazardous air quality. According to the World Air Quality Report prepared by IQAir, Delhi appeared fourth on a list of 50 of the world’s most polluted cities in terms of PM2.5 levels in 2022. Mumbai experienced a 110% increase in the past four years whereas Lucknow, Patna, Bengaluru, and Chennai observed a decline in PM2.5 levels, with Chennai experiencing a 23% decrease in 2023.
The Invisible Enemy
Emerging evidence suggests a connection between air pollution and psychotic disorders. A study suggested that poor air quality during the early years of an individual’s life increases the risk of psychiatric disorders, including bipolar disorder, schizophrenia, personality disorder, and major depression.
“Schizophrenia patients are generally living in their own world which is disconnected from our reality-based world. Now if we don’t give them a chance to engage in this environment and connect with people around them, their self-isolation will ultimately worsen their mental disorder,” explains Dr Sanjay Ramanlal Kumawat, a Mumbai-based psychiatrist.
A study from researchers at Harvard, published in March 2023, adds to the evidence connecting exposure to air pollution (small particulate matter (PM2.5), nitrogen oxide and nitrogen dioxide) to increased risk for dementia. Incessant exposure has been linked to cognitive decline in older adults, accelerating the onset of neurodegenerative diseases such as Alzheimer’s and dementia. Dr Sanjay says, “Due to the air pollution senior citizens are forced to stay indoors which results in the loss of social connectivity. This aggravates the genesis of dementia. In an environment where one is confined within four walls, new learning also becomes difficult for them.”
Even kids exposed to 24x7 air pollution can suffer from cognitive impairments and poor academic performance. Dr Sanjay adds, “Certain pollutants like nitrogen oxide and nitrogen dioxide have a direct effect on the certain areas of the brain which control the emotions and behaviours of people that lead to the issues of learning disabilities and cognitive behavioural issues. It aggravates anxiety, depression, bipolar disorder, schizophrenia, and mood swings that elevate irritability and frustration levels.”
The Deadly Haze
The silent killer of several deaths in India, air pollution is a mystic haze that is usually caused by crop burning, vehicular emissions, dust storms due to construction activity, and industrial emissions. Air pollution is not a singular foe but a complex amalgamation of pollutants that are numerically valued in the form of AQI (Air Quality Index). Fine particulate matter (PM2.5), nitrogen dioxide, sulphur dioxide, ozone, and volatile organic compounds constitute a toxic concoction that infiltrates the lungs with every breath. As per researchers these pollutants taint the respiratory system and even human minds. Yashi Srivastava (26), a resident of Lucknow and a mental health campaigner says, “Post Diwali, the air had a strong smell. For a few minutes, I found it difficult to breathe.” Yashi would go for morning walks and meditate in the open, but the air quality was terrible. “It made me feel even more stressed and negative,” she adds. Her stress led to PCOD and TMJ (temporomandibular joint problems).
Elevated levels of stress hormones, such as cortisol, have been observed in individuals exposed to high concentrations of air pollution. Scientific studies have established a compelling link between increased levels of air pollution and heightened anxiety levels. The presence of particulate matter has been found to correlate with increased activity in the amygdala, the brain’s fear centre, triggering a heightened state of vigilance and anxiety. The perpetual exposure to polluted air creates a persistent state of stress, contributing to the rise in anxiety disorders.
Eco-anxiety Problem
While the exposure to air pollution might be short-lived, anxious young people are experiencing eco-anxiety due to exposure to alarming news about climate change. Eco-anxiety is extreme worry about the present-day situation and future harm to the environment caused by human activity and climate change. Long-term exposure to air pollution has been associated with an increased risk of depression, with the inflammatory response triggered by pollutants potentially affecting neurotransmitter function. As the haze of toxic pollutants brings gloominess to the sight, it does the same to the human mind. Without enough exposure to the sun, serotonin levels can dip resulting in a higher risk of depression and anxiety.
Experts Speak
According to researchers Uttara Balakrishnan and Magda Tsneva from the American Institute for Research, both men and women have worse mental health outcomes because of air pollution exposure. The impact is worse on women. “Women are less likely to have access to healthcare compared to men in India (Baru et al. 2010). This potentially makes them less likely to seek care for the physical health impacts of air pollution exposure, which could have a detrimental effect on mental health. Also, women have worse mental health outcomes than men to begin with (Boyd et al. 2015; Seedat et al. 2009), not least because of gender-based violence (Kumar et al. 2005),” says Uttara. They also found out that urban and rural areas can potentially have different effects due to at least three reasons.
“Differential exposure to outdoor air pollution, differential access to pollution information and mitigation measures, and differential access to healthcare. Both rural and urban populations experience negative effects of air pollution exposure on mental health with similar effect sizes,” she explains.
The fight for mental well-being must begin at an individual level. People should stop buying multiple private vehicles.
There needs to be stricter regulations on industrial emissions. Incentivizing cleaner technologies, and investing in sustainable urban planning are critical steps in curbing the rising tide of air pollution.
