We are always told to never mix work and friendships in social settings. While it is normal to make friendships at work, you should always keep a professional distance to make sure things do not go sour and start affecting your work. This also means that you do not divulge private information or have private conversations with your colleagues as you may never know how this could be brought up and affect you. This is an unsaid rule in corporate culture that if you are sick or you are coming down with a serious issue, you should never bring it up and keep it to yourself. While this may seem unusual to new workers, it is a very common knowledge for people who have been in the industry for a long time. A new study showed that this is much more common than many people believe!

A new poll shows that a lot of U.S. workers with long-term health problems keep it a secret from their bosses. This affects their health and their jobs. It's a big problem that employers could help fix, which would be good for everyone. This isn't just about people having a sniffle. We're talking about serious conditions like heart disease, diabetes, and asthma that require ongoing management and can significantly impact a person's life, both inside and outside of work. The fact that so many people feel they need to hide these conditions shows a larger issue of stigma and lack of support in the workplace.

How Does Health Become A Hidden Burden?

Most U.S. workers which were over half of the people, have some kind of long-term health problem. But a lot of them, about 6 out of 10, don't tell their boss. They might be afraid their boss will treat them differently or think they can't do their job. Keeping secrets like this can make it hard to get the help you need at work. It can also make your health problems worse because you're stressed about hiding them. It's a tough situation, and it shows that many workplaces aren't as supportive as they could be.

The poll also found that more than a third of people with health problems have had to miss doctor's appointments because of work. This means they're putting their jobs ahead of their health, which isn't good. It's hard to balance work and health, especially when you have a long-term illness. People need understanding bosses who will let them take time off for important medical stuff. Missing appointments can make health problems worse, and it can also make people feel more stressed and anxious.

Does It Impact Their Career And Well-Being?

Almost half of the workers with health problems said they couldn't even take breaks during the day to take care of themselves. They also said they felt like they'd been passed over for promotions because of their health. And some people even got bad reviews at work because of their health problems. This can make people feel really bad about themselves and their jobs. It can also make their health problems worse because they're so stressed. It's not fair, and it's something that needs to change.

It's not just people with health problems who have a hard time. Lots of people are also taking care of someone at home who is sick. Almost half of these caregivers have to help their sick family member during work hours. And many of them have trouble taking time off to care for their loved ones. Some people even have to work fewer hours, which means less money. This shows how much pressure people are under, trying to juggle work and family and health.

Climate change is not just raising temperatures and intensifying extreme weather. It may also affect digestive health by disrupting food production, threatening water security and changing the spread of gastrointestinal infections, according to two leading gastroenterology experts from the World Gastroenterology Organization (WGO).

Climate change can contribute to heat-related illnesses and influence the geographic spread of infectious diseases, especially in countries like India.

A February 2025 review in The Lancet Planetary Health outlines how the combined effects of climate change could affect the human gut microbiome, including through food insecurity, malnutrition and exposure to disease-causing pathogens. These challenges could alter the composition of gut microbial communities worldwide.

Research suggests that heat stress may alter gut microbes, digestion and immune function. It may also increase intestinal permeability, potentially allowing toxins and pathogens to enter the bloodstream.

Climate-related drought can disrupt food production and reduce access to nutritious food, potentially affecting the gut microbiome. Environmental changes may also influence food- and waterborne pathogens, increasing infection risks where access to safe water and sanitation is limited.

Speaking to HealthandMe, Professor Geoffrey Metz, professor of medicine at the University of Melbourne, said climate change was becoming an increasing concern for gastrointestinal health.

“Certainly, with global warming, we're seeing a lot more infectious diseases in the gastrointestinal tract,” Metz said.

How Climate Change Can Affect Digestive Health

Also read: 'Humanity Can Still Act': Lancet Warns Of 17 Global Health Threats By 2100

Climate change can affect digestive health through several interconnected pathways, including water availability, food production and infectious diseases.

Metz said the consequences of global warming extend beyond rising temperatures.

“The other thing, of course, with global warming—and this is a major interest of the World Gastroenterology Organisation—is that it's not just making us hot, but it's also creating more drought, which interacts with food production. So there's less food available, impacting our nutrition.”

Drought can disrupt food production and reduce food availability, raising concerns about nutrition. Changes in water availability can also make safe food preparation and hygiene more difficult.

However, the extent to which these environmental changes contribute to specific gastrointestinal diseases requires further investigation.

Safe Water And Food Hygiene Remain Essential

Professor Carolina Olano, professor of gastroenterology in Montevideo, Uruguay, and president of the WGO, highlighted the role of environmental factors in digestive diseases.

“Well, I think it's a combination of many factors. You know that there are some things related to genetics, and we have genetic predispositions to some diseases. But there are also environmental factors related to different diseases, and climate change has an impact too. We are working very hard at the World Gastroenterology Organisation to understand how climate change is affecting different diseases.”

Olano also emphasised the importance of safe drinking water and food hygiene in preventing infections.

“It's also important to have a varied diet and to drink safe, clean water, making sure that the water we drink is safe. Food hygiene is also extremely important.”

She told HealthandMe that handwashing was another simple preventive measure.

“We learned from the COVID pandemic that handwashing before eating is extremely important. These are things we can do every day without spending anything, and they can help prevent many important diseases, especially those related to infections.”

Climate Change Has Wider Health Consequences

Read More: Climate Change Is Affecting Skin Health Worldwide, Warns Study

The effects of climate change may extend beyond the digestive system, affecting multiple aspects of health.

“Global warming is not just affecting how we feel; it's also having an effect on heart disease, lung disease, gastrointestinal disease, obstetrics and gynaecology,” said Metz, who is also the former president of the WGO.

Olano also pointed to population movements as a factor to consider when assessing environmental and health risks.

“As you know, it's not only about weather and climate change. It's also about how populations move from one country to another and what the impact of these movements is when people move from one region to another.”

“Because, as you know, it's not only about weather and climate change. It's also how populations move from one country to another and what the impact of these movements is when people move from one region to another.”

Understanding these connections is important as researchers investigate how climate-related environmental changes may influence disease patterns across regions.

What Can People Do To Protect Their Digestive Health?

While individuals cannot control climate-related changes, Olano highlighted everyday measures that can help prevent infections and support digestive health:

• Drink safe, clean water.
• Maintain food hygiene and handle food safely.
• Wash hands before eating.
• Follow a varied diet.
• Stay physically active.

She also stressed the importance of seeking medical advice about hepatitis prevention, vaccination and testing where appropriate, as well as colorectal cancer screening.

Climate change presents a broader public health challenge, but safe water, food hygiene and infection prevention remain important measures for reducing avoidable digestive health risks.

Depression affects millions of people worldwide, but not everyone responds equally well to treatment. Now, researchers at the University of Sydney have identified a new subtype called “circadian depression,” which is linked to the body’s internal clock and may help explain why conventional antidepressants work less well for some people.

The subtype was identified in nearly a quarter of participants with severe, recurrent or persistent depression in an Australian study. Researchers say recognizing its characteristics could help clinicians identify patients who may benefit from different treatment approaches.

“Our research has identified circadian depression as a new subtype, affecting around a quarter of people in our study into those with severe, recurrent or persistent depression,” said Dr. Emiliana Tonini from the Brain and Mind Centre at the University of Sydney.

“Depression is not a uniform illness and understanding the characteristics of different subtypes mean that we can give people earlier access to treatments that will be most effective for them,” she added.

Circadian Depression: What Are The Key Symptoms?

Also read: Burning Skin, Panic Attack & Depression: ‘Godzilla’ Weight Loss Drug Retatrutide Linked To 129 Symptoms

Circadian depression is linked to the body’s 24-hour internal clock, which regulates the sleep-wake cycle. Researchers identified several symptoms and characteristics associated with this subtype, including:

• A seasonal pattern of illness

• Sleeping longer during depressive episodes

• Waking up feeling very tired

• Being a night owl

To investigate the subtype, researchers analyzed clinical and genetic data from more than 10,000 people with depression who participated in the nationwide Australian Genetics of Depression Study.

Of these, 2,604 participants, or nearly 25%, were identified as having circadian depression.

The researchers also found that people with this subtype were more likely to experience depression earlier in life and had more severe symptoms, including mania and higher levels of suicidal thoughts.

In addition, these participants had a higher genetic risk for inflammatory and cardiovascular health problems, as well as major neurodevelopmental disorders, including attention-deficit/hyperactivity disorder (ADHD).

The findings, published in the British Journal of Psychiatry, offer insights into the genetic mechanisms associated with circadian depression and may help explain why conventional treatments, such as selective serotonin reuptake inhibitors (SSRIs), work less well for some people with this subtype.

How Does Circadian Depression Differ In Treatment Response?

Antidepressants such as SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly used to treat depression. However, the researchers reported that these medications were less effective and associated with more side effects in people with the circadian subtype.

Because circadian depression is linked to the body’s internal clock, treatments targeting circadian rhythms may be relevant for some patients. These include light therapy, melatonin and melatonin-targeted antidepressants.

“Because circadian depression is linked to people’s internal body clock, treatments targeting the circadian rhythm, such as light therapy and melatonin, may be much more relevant, and clinicians should reach for these much earlier in people with this presentation,” said Dr. Jacob Crouse, co-senior author of the study, from the Brain and Mind Centre.

“For those who find that antidepressants are not working for them, it is important to speak to your clinician for advice about your individual circumstances,” he added.

Professor Ian Hickie, co-director of the Brain and Mind Centre and a clinical psychiatrist, emphasized that failing to recognize circadian depression in young people could contribute to early treatment failures and more side effects.

“We really want young people to receive the most appropriate treatment early in their course of illness.

“Most young people will be offered SSRIs first up, but for at least a quarter there are better circadian-focused medical and behavioural options to help treat and manage their condition.”

The findings suggest that identifying circadian depression could help clinicians consider more tailored treatment approaches. However, the study does not establish that body-clock disruption causes depression or that every person identified with this subtype will respond better to circadian-focused treatments. Patients should consult their clinicians before making any changes to prescribed medication, the experts said.

In India, breast cancer is the most diagnosed cancer among women and the leading cause of cancer-related deaths in women. According to the International Agency for Research on Cancer’s GLOBOCAN 2024 estimates, the country recorded approximately 237,231 new cases and 96,100 deaths. Across both sexes, it is the second leading cause of cancer death.

The median age of diagnosis among Indian women is 51, nearly a decade younger than in most developed countries. One hospital-based study estimates that 25% of cases occur in women under 40, underscoring the importance of breast awareness, timely symptom evaluation, clinical examination and individual risk assessment. The Breast Imaging Society of India recommends mammography screening from age 40, considering individual risk and available resources.

Breast cancer risk does not suddenly begin at a particular birthday, and two women of the same age may have very different risk profiles. Women should be encouraged to become familiar with the usual appearance and feel of their breasts and to seek prompt clinical evaluation for unexplained breast changes. In India, where breast cancer often presents at a comparatively younger age and access to high-quality imaging is uneven, discussions about early detection should extend beyond age alone. Family history, inherited susceptibility, previous breast findings and other recognized risk factors can help determine whether a woman may benefit from earlier assessment, specialist referral or additional imaging.

Why individual risk matters

A risk-informed approach should consider several factors:

• Family history: Breast or ovarian cancer in close relatives, particularly diagnoses at younger ages, cancer affecting both breasts, male breast cancer, or multiple affected relatives may indicate inherited susceptibility. This may warrant earlier risk assessment before age 40.

• Genetic factors: Women with BRCA1 or BRCA2 gene variants may also require earlier than average-risk screening, starting as early as age 25.

• Breast density: Dense breast tissue can lower the sensitivity of mammography and is independently associated with breast cancer risk. Supplemental imaging such as MRI may be considered in selected women, based on the overall risk, the quality of available imaging and the potential for false-positive results and unnecessary biopsies.

• Previous breast findings: A previous high-risk breast lesion, atypical biopsy result or suspicious imaging finding may change the recommended screening frequency or method. Women with such findings should follow an individualized plan developed with their physician.

Also read: Breast Cancer: Are Women in India Being Diagnosed Too Late?

Persistent inequalities in access

Access to breast assessment, imaging and specialist interpretation remains highly unequal across India. The lifetime prevalence of breast cancer examination is only 8.8 per 1,000 women, with uptake varying by education, economic status and geography. High uptake among educated, affluent, and urban women, especially in southern India, highlights how social determinants and health system barriers shape access to breast cancer screening. India also faces shortages and maldistribution of imaging specialists, with approximately one radiologist per 100,000 people, compared with one per 10,000 in the US. Specialists are disproportionately concentrated in urban areas.

Addressing these inequalities requires more than awareness campaigns. Priorities include strengthening clinical breast examination and referral pathways, training frontline health workers, expanding access to diagnostic imaging and pathology, ensuring timely follow-up after abnormal findings, and monitoring outcomes across socioeconomic and geographic groups.

Also read: World Breast Cancer Day 2026: Life After Breast Cancer, The Fear No One Sees

Where artificial intelligence could support early detection

Artificial intelligence (AI) is being evaluated as a potential support for breast cancer detection in settings where imaging capacity and specialist availability are limited. Depending on the technology and clinical context, AI may assist with triage, image interpretation, workflow prioritization or risk estimation. Its clinical value depends on appropriate validation, reliable referral pathways, diagnostic confirmation, quality assurance and ongoing monitoring for unequal performance across population groups.

Integrating community health workers, portable AI technology and digital referral pathways within primary health care could potentially help reach women who face geographic, financial or health-system barriers. The most important feature is not the algorithm alone, but the complete pathway linking awareness, initial assessment, referral, diagnostic confirmation and treatment. AI output is not a diagnosis. It must be interpreted alongside the patient’s clinical history, risk factors, examination findings and appropriate diagnostic imaging.

Translating personal risk into informed screening decisions

For women, a more personalized approach does not mean performing more tests in every case. It means identifying those who may benefit from earlier, more frequent or different forms of assessment while avoiding unnecessary imaging and procedures among women unlikely to benefit.

As part of a shared decision-making conversation, women may wish to ask their physician:

• Based on my age and personal risk factors, when should breast cancer screening begin?
• Does my family history suggest that I need a formal risk assessment?
• Would referral for genetic counselling be appropriate for me?
• If I have dense breasts, how does that affect the interpretation of my mammogram and my overall risk?
• Do previous breast symptoms, imaging findings or biopsy results change my follow-up plan?
• Which screening or diagnostic services are available locally, and what follow-up will be provided if an abnormality is found?
• Would a formal breast cancer risk-assessment help guide my screening plan?

Breast Cancer Awareness Month is an opportunity to advocate for equitable care pathways, from risk assessment and early detection to diagnosis and timely treatment. In India, a key challenge is ensuring every woman with a concerning symptom or abnormal finding receives appropriate assessment, diagnostic confirmation and treatment without avoidable delays.

Preparing future physicians for evolving healthcare needs is central to medical and public health education at St. George’s University School of Medicine. Through a diverse, international learning environment and clinical exposure, students develop the medical knowledge, clinical skills and professional competencies needed to care for diverse patient populations.

By Dr. Tonia Frame, Assistant Professor and Director of the Global Health Unit in the Department of Public Health and Preventive Medicine at St. George’s University