Mental Health Disorders (Credit: Canva)
How often do you hear people calling each other "psychopath"? Or how often do you witness people labelling themselves as "bipolar" or "depressed"? Quite frequently. Right? These are names of some serious, often life-threatening mental disorders which have been included in common vocabulary. Ayushi Jolly, a PhD scholar opined that "mental health disorders are not adjective to be thrown around."
Obsessive Compulsive Disorder (OCD)
Today, many people who are organized and prioritize santitation and hygeine, label themselves as suffering from OCD. However, in psychology, OCD is a long-lasting disorder in which a person experiences uncontrollable and recurring thoughts (obsessions), engages in repetitive behaviours (compulsions), or both. This condition can significantly impair daily functioning, leading to severe anxiety and distress. Without proper treatment, it can escalate, affecting relationships, work, and overall quality of life.
Depression
"I am so depressed, I act like it's my birthday everyday," these are lyrics from a chart-topping Taylor Swift song. However, the singer-songwriter has never been diagnosed for the same. Similarly, people throw away the term even at the slightest discomfort. But, this mental health disorder is life-thretening, serious mood disorder. It causes severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working. Note, to be diagnosed with depression, the symptoms must be present for at least 2 weeks.
Attention Deficit Disorder (ADD)
Any person who is high on energy and gets distracted easily could be heard saying "I'm suffering from ADD." In reality, ADD is a type of attention-deficit/hyperactivity disorder (ADHD) that's characterized by problems with concentration and focus. ADHD is a developmental disorder that can affect a person's daily life, including their ability to perform at school or work and their social relationships.
Bipolar Personality Disorder
Broke up with your partner? Chances are you'll end up calling them bipolar. The terms has also been used in various films and songs, sans the knowledge of it's seriousness. Formerly known as manic-depressive illness or manic depression, this condition is a lifelong mood disorder that causes intense shifts in mood, energy levels, thinking patterns and behavior. A person suffering from this disorder witnesses intense shifts in mood, energy levels, thinking patterns and behavior, for long periods of time.
Paranoid Personality Disorder (PPD)
Being "paranoid" has become more like a negative adjective among teens and young adults. However, a person who suffers from this condition is incapable of maintaining succesful relationahips. Paranoid Personality Disorder (PPD) is a group of personality disorders categorised under "Cluster A". A person with PPD thinks in odd or eccentric ways, and suffers from unrelenting mistrust or suspicion of others, even when there is no reason to be suspicious. This disorder usually begins in early adulthood and appears more common in men than women. People with PPD are always on guard, believing that others are constantly trying to demean, harm, or threaten them. People with this disorder also doubt the commitment, loyalty, or trustworthiness of others. PPD patients also might have difficulty relaxing.
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She came to the hospital because of a cough that would not go away. The cough was eventually found to be nothing serious. But her CT scan revealed something unexpected — a 12 mm nodule in the outer part of her right lung.
She had never smoked. She felt completely well.
Yet that tiny shadow raised a big question: was it an old tuberculosis scar, a harmless growth, or an early lung cancer?
A CT scan can show us that a nodule is there. It cannot always tell us what it is.
This is an increasingly familiar situation. As CT scans have become more widely used, particularly after the COVID-19 pandemic, doctors are finding small lung nodules in people being scanned for entirely different reasons. Most turn out to be benign. Some, however, need closer assessment.
India has another challenge. Tuberculosis and its scars are common, and a lung shadow can sometimes be attributed to TB without tissue confirmation. While treating tuberculosis promptly is important, assuming that every suspicious nodule is TB can occasionally delay the diagnosis of something else, including cancer.
The answer, when appropriate, is to obtain a tissue sample.
Traditionally, a small nodule deep in the lung could be difficult to reach. A needle biopsy through the chest can be effective but carries a risk of a collapsed lung. Conventional bronchoscopy is excellent for the larger airways but becomes more challenging as the target gets smaller and farther towards the edge of the lung. Surgery may sometimes be necessary.
Navigation bronchoscopy uses the patient's CT scan to create a three-dimensional map of the airways and guide a thin catheter towards the nodule. Cone Beam CT adds real-time three-dimensional imaging during the procedure, allowing the doctor to check where the instruments are in relation to the lesion before taking the biopsy.
In simple terms, navigation helps us find the way; Cone Beam CT helps us confirm we are there.
The tissue can then be examined immediately where appropriate, helping determine whether the sample is adequate and whether additional material is needed for advanced testing.
Importantly, not every nodule needs a biopsy. Many are best managed through carefully planned follow-up scans. The decision depends on the nodule's size and appearance, previous scans, and the patient's overall risk.
For patients, the message is reassuring: a lung nodule does not mean cancer. But it should not be ignored either.
Keep previous scans. Ask what the likely possibilities are. Understand why your doctor recommends surveillance or biopsy — and make sure the follow-up happens.
Today, advanced bronchoscopy is helping doctors turn a worrying shadow into something much more useful: an answer.
(By Dr Shyam Krishnan, Intervention Pulmonologist, CMRI)
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Second-hand smoke increases the risk of lung cancer in people who have never smoked because it contains harmful chemicals, including known cancer-causing agents. When someone who does not smoke is around a person who is smoking they breathe in smoke from the burning cigarette and the smoke that the smoker breathes out. This mix of smoke is called second-hand smoke or environmental tobacco smoke.
Even though the non-smoker does not light a cigarette they still take in dangerous substances. These chemicals can irritate the lungs. Cause inflammation. They also create stress, which means the body’s natural defenses are overwhelmed by harmful molecules. Over time this damage can harm the DNA inside lung cells.
When DNA is damaged the cells may start to change in ways. These abnormal cells can grow out of control. Turn into cancer. The longer and more intense the exposure to second-hand smoke the higher the risk becomes. For example, people who live with a smoker or work in places where smoking is allowed may get exposure over time.
Second-hand smoke also makes it harder for the body to fix cells. It keeps the lungs in a state of inflammation. This ongoing irritation helps create a condition where cancer can start and grow.
There is no level of exposure to tobacco smoke. Even small amounts can add to the risk. Some people are especially at risk like children, pregnant women and those with asthma or other breathing problems.
The best way to prevent lung cancer from second-hand smoke is to reduce exposure. This means keeping homes, cars and workplaces completely smoke-free. It also means supporting smoke- policies and encouraging people to quit smoking. Protecting non-smokers from second-hand smoke is a step, in reducing lung cancer rates.
Dr Saket Kumar, Senior Consultant – Physician & Pulmonology, Sterling Hospitals, Bhayli, Vadodara
Credit: Guy's and St. Thomas Specialist Care
Dry cough and breathing difficulty aren’t always caused by asthma, COPD, or infections. They can also be signs of interstitial lung disease (ILD), a group of lung conditions that can cause inflammation and scarring and, in some cases, progressive loss of lung function.
ILD can go unnoticed in its early stages because its symptoms are often mistaken for more common respiratory conditions. By the time a patient undergoes a CT scan and reaches an ILD clinic, significant lung scarring may have already developed — and some of that damage may be irreversible.
A Global Burden of Disease Study 2023 analysis, published in December 2025, estimated that 4.58 million people were living with ILD and pulmonary sarcoidosis worldwide in 2023, with 112,650 deaths attributed to the conditions that year.
“The true global burden of ILD is higher than currently reported, particularly in underserved populations and low- and middle-income countries,” Prof. Marlies Wijsenbeek-Lourens, Pulmonologist and Head of the Center for Interstitial Lung Diseases and Sarcoidosis at Erasmus University Medical Center, Netherlands, told HealthandMe.
The global expert said most available epidemiological data come from Europe, North America, Japan, South Korea and Australia, where access to specialist care, multidisciplinary diagnosis and high-resolution CT imaging is generally more available.
“As a result, large parts of Africa, South America, South and Southeast Asia remain underrepresented in current estimates. In these regions, more limited access to diagnostic facilities, fewer ILD specialists and under-recognition of disease undoubtedly result in substantial underdiagnosis.”
Even in high-income countries, she added, some patients with ILD likely remain undiagnosed because symptoms such as breathlessness and cough are often attributed to more common conditions.
ILD is not a single disease but a group of more than 200 lung conditions. The disease affects the interstitium, the tissue surrounding and supporting the lungs’ air sacs, or alveoli. In ILD, this tissue can become inflamed and/or scarred.
As scarring progresses, the lungs can become stiffer, making it harder for them to expand and reducing the efficiency of oxygen transfer. As the disease progresses, the lung shrinks, making it difficult for the patient to breathe.
According to Prof. Marlies, there is a rise in ILD diagnoses due to several factors, such as:
Some forms of ILD can be treated more effectively when identified early, before permanent lung damage occurs.
“Unfortunately, many patients still reach an ILD specialist late. Breathlessness and cough may initially be treated as asthma, infection or sometimes even tuberculosis. By the time a CT scan is done and the patient reaches an ILD clinic, significant scarring may already have developed,” Dr Asmita Mehta, Professor and Head, Department of Respiratory Medicine at Amrita Institute of Medical Sciences, Kochi, told HealthandMe.
“A dry cough and gradually progressive breathlessness lasting for more than three months, particularly breathlessness while walking or climbing stairs, should raise suspicion of ILD rather than simply being attributed to asthma, infection or ageing,” she added.
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Doctors should think of ILD especially when these symptoms do not improve with usual treatment, when fine crackling sounds are heard in the lungs, or when oxygen levels fall during walking.
It is also important to ask about joint pain, skin changes, dry eyes or mouth, and exposure to birds, mould, biomass smoke or occupational dust. Sometimes the clue to ILD is outside the lungs, the expert said.
Pre-existing ILD was associated with worse outcomes during COVID-19. Now, six years later, some patients who had severe COVID-19 also continue to show persistent lung abnormalities.
“The reassuring part is that not every abnormal CT after COVID means progressive lung fibrosis. In many patients, the lung changes gradually improve or remain stable. Some patients who had very severe COVID, prolonged ICU admission, or required ventilation may be left with persistent scarring and may need longer follow-up,” Dr Asmita said.
Common ILD diagnoses seen in India include connective tissue disease-associated ILD (CTD-ILD), hypersensitivity pneumonitis (HP), idiopathic pulmonary fibrosis (IPF), sarcoidosis and idiopathic nonspecific interstitial pneumonia (NSIP).
Dr Asmita said that, apart from idiopathic pulmonary fibrosis, ILD related to autoimmune diseases and environmental exposures is also commonly seen in India. These exposures can include birds, mould, biomass smoke and certain occupations.
Epidemiological reviews estimate the overall prevalence of ILD in India to range between 49.0 and 98.1 per 100,000 people, with an annual crude incidence rate of 10.1 to 20.2 per 100,000 population.
India is also building a larger national evidence base through the ICMR-led Indian Network of Pulmonary Fibrosis (INPF) registry.
“We therefore need not only earlier diagnosis, but better awareness, affordable treatment, wider access to ILD specialists and stronger advanced-care and transplant programs,” Dr Asmita said.
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