Many years ago while training as a psychiatrist in Edinburgh, I was struck by an unusually high number of journalists who were frequenting the psychiatric out-patient clinic. More than 35 years ago, there were anecdotal reports that journalists were more prone to mental illnesses but there were no good epidemiological studies that were available to rely upon.

Certainly the incidence and prevalence of alcoholism was unusually high even by the Scottish standards. In my list, I had five of the most well known journalists in Scotland in addition to several rookies who were battling this malady. The only epidemiological study that we could rely upon was by my colleagues Keith Rix and Martin Plant in which they discovered that next to publicans and fishermen, journalists had an alarmingly high incidence of alcohol-related problems. But there was a remarkable difference between these groups. While the fishermen and publicans were only too ready and willing to seek professional assistance, the journalists were invariably loathe to do so. Every media person that I came across in my clinic was doing so because he or she had been compelled by his/her employers. Unsurprisingly, the incidence of marital breakdown was very high in this group. Even concomitant physical problems like cirrhosis of liver did not act as a deterrent. I recall dropping off a note to Vincent Hanna – the Secretary of the Union of Journalists at the time – apprising him of the seriousness of the problem and the attention it merited from the trade union. Vincent acknowledged my note and assured me that it would be looked into.

Later on when I moved trans-Atlantic, I was intrigued to observe the same problem among the journalist community there. The most disconcerting feature was that this was not a closely guarded secret – it was known to every journalist I spoke to or corresponded with. Yet there was absolutely no compelling fraternal obligation on their part to alert the populace of the menace their own brethren were experiencing. To me this lapse was reflective of unforgivable apathy. And I must remark how outwardly the journalists always swore how important it was to look after the welfare of their colleagues.

It was while I was in North America that a few landmark epidemiological studies were conducted that tended to illustrate that journalists were not just prone to alcoholism and alcohol-related problems, but also had a very high incidence of marital breakdowns (in fact I cannot recall any senior journalist I associated with over there who had not been divorced at least once!) . There was also a very high incidence of anxiety disorders and Obsessive Compulsive Disorder. Roger Tonk’s survey indicated that journalists were fifth from the top when anxiety disorders were being investigated and eighth when OCD was considered – which is far above the population average.

His study and the other studies also confirmed the disconcerting feature of the Scottish survey – the reluctance among the media persons generally to seek professional help. Only a very tiny percentage were doing so and an even smaller percentage was seeking psychotherapy or the counselling that was readily available.

While I was unable to conduct a formal epidemiological survey, I was also struck by a disturbingly high number of young female journalists who had contracted anorexia nervosa/bulimia nervosa for which a lengthy treatment is required. Needless to say, they were not inclined to seek this help unless there were other social reasons that were compelling them to do so. The incidence of attempted suicide was particularly high in this group of patients.

I also need to point out that I spent several years in Philadelphia which is the Mecca for Cognitive Therapy – treatment of choice for anorexia nervosa! And yet the treatment was not being availed of in that metropolis.

While dealing with veterans in the Veterans Administration Hospital, I discovered to my surprise that there was another condition that was unusually highly represented among the journalist community. The Diagnostic and Statistical Manual of the American Medical Association appellates this condition as Post Traumatic Stress Disorder or PTSD.  When I started training, such an entity was unknown but seems to have entered the medical colloquium now. For a diagnosis of this condition, what is required is exposure to a traumatic event, persistent re-experiencing of the event, persistent avoidance and emotional numbing, and hyper-arousal for more than four weeks.I personally have expressed my serious concern at this diagnostic label and outlined that in the Military Medicine Oration I was asked to deliver at Marime Medical Society Conference in Bombay in October 2012. To me the condition is no more that a learned physiological response manifesting itself over an abnormal period and does not deserve a separate label.

All the epidemiological surveys indicated that the incidence of PTSD in the media was comparable to that in the military personnel.

Years later, when I worked in Gothenberg,Sweden ,I discovered the same reluctance among the members of the journalistic community to seek professional help. Despite full knowledge that a problem of this magnitude exists and is ignored at peril.

It would be apposite here to remark on my experience in India ever since I relocated in this regard. I live in a mofussil town and not a metropolis – and even here I have come across two cases of anorexia nervosa in the past year .Both these young girls were working in television where body image is of supreme importance. They were made to seek assistance after the condition began to have unacceptably negative implications professionally.

One of the lady journalists who sought my assistance was in her late Twenties and worked with a major television channel as a presenter. I could see nothing wrong with her figure and by and large she had a very friendly predisposition. However she had, after working for nearly five years, developed a feeling that her body was poorly shaped and that she was overweight. In reality, she was about 170 cms tall and weighed less than 50 kilos. She had taken to exercising almost with a manic fervour in order to reduce her weight. Occasional remarks by some insensitive colleagues did not help matters. She became increasingly withdrawn and this began to affect her professionally. Her news editor, a lady herself, started chiding her publicly which led to the plummeting of her self-esteem. One day she was discovered by her colleague, a cameraman, taking weight loss pills which contained an amphetamine-like compound which is known to be extremely dangerous. He tried to warn her but was not able to persuade her to seek help. One day after lunching in the cafeteria, she was found inducing herself to throw up in the lavatory by another colleague who reported her to the local boss. Following which she was compelled to seek psychiatric help.

The other anorexic lady journalist was referred to me by her physician after attempting suicide.

I shall not even mention the number of journalists I have examined who have had serious anxiety problems and alcohol-related difficulties and one a case of Combat trauma. I would imagine the problems would be even more acute in metropolitan cities.

Therefore, I was specially relieved when I came across a very erudite paper authored by DrAoki and his colleagues from Tokyo along with Professor Thornicroft and his colleagues from London which looked specifically at the problem of mental illnesses among the journalist community (published in International Journal of Social Psychiatry in 2012). To the best of my knowledge this is the most comprehensive international survey on the subject.

Its conclusions – “prevalence of post-traumatic stress disorder (PTSD) among journalists is higher than that among the general population. Journalists have positive personal attitudes towards mental illness, but there are perceived workplace disincentives to disclose mental health problems.”

It is the identified “workplace disincentives to disclose mental health problems” that should alert us all. Sooner rather than later.

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