For most, eating is a simple, routine activity- sitting down to share and enjoy a meal with friends or family or simply in solitude. But for Elise Baynard, a 25-year-old healthcare assistant from Dover, Kent, eating is far from normal. A rare condition known as achalasia has rendered swallowing food almost impossible, leaving her vomiting up to 60 times a day and having to stand to eat in order to avoid choking. The illness has not only impacted her physical well-being but also severely affected her mental health.

Elise's experience with achalasia started in January 2020, when she suddenly began to have trouble swallowing. What began as a slight discomfort quickly developed into a sensation of tightness in her chest, which made it hard to eat even simple foods. Her GP initially diagnosed her with acid reflux and prescribed medication, but the medication did little to ease her symptoms.

Gradually, the condition worsened. Bread and pasta were impossible to consume, and even swallowing liquids was a chore. As her health continued to decline, Elise lost an enormous amount of weight, reaching only seven stone. Fed up and eager for solutions, she consulted with specialists, who consistently "fobbed her off" as her condition remained undiagnosed for years.

Following referral to a gastroenterologist in 2021, Elise had several tests, including an endoscopy. These were all normal, and she was left without a diagnosis. It wasn't until November 2024 that she was referred to a specialist in London, who diagnosed her with achalasia—a rare condition where the muscles of the esophagus do not contract normally, so food cannot pass into the stomach.

The diagnosis was established by a manometry test, which detects movement of muscles within the esophagus. "There is no activity in my throat—it's basically broken," Elise said. "It's not a death sentence, but it's no way to live."

What's It Like Living With Achalasia?

For Elise, each meal is a struggle. Unlike most individuals, she is unable to sit down to eat, since gravity is instrumental in getting her food into her stomach. "I have to stand up when I eat, so the food actually goes down," she explained. Even with this accommodation, she still experiences severe regurgitation, which can happen as many as 60 times a day.

One of the most excruciating aspects of her condition is the esophageal spasms. "It literally feels like having a heart attack," she described. "Some days, I’m sobbing on the floor in pain." These spasms cause intense pain in her jaw, neck, and back, making daily life incredibly difficult.

Beyond the physical challenges, achalasia has severely impacted Elise’s mental health. The constant struggle to eat has led to an overwhelming fear of food. "It’s always on my mind, and I’m developing a fear of eating," she admitted. "It affects every part of my life."

Social interactions have grown to be more challenging. Going out to eat with friends is well nigh impossible, and even informal dining at home is filled with tension and discomfort. The loneliness that accompanies her illness has made her feel stuck in a pattern of pain and worry.

Is There A Treatment for Achalasia?

In spite of the difficulties, Elise holds on to hope that a specialist procedure known as peroral endoscopic myotomy (POEM) might give her a way back to a normal life. It is a minimally invasive procedure where muscle is cut along the lower esophagus to dilate the opening and enable food to flow more freely into the stomach.

However, she faces a long wait for a referral from her specialist. "I have to wait for my specialist to refer me for the procedure. But it took years to get a diagnosis—I don’t know how long this will take," she said. "I’m desperate for the procedure."

Without the surgery, Elise worries that her condition will continue to worsen, making day-to-day tasks even more difficult. "I just want to be able to eat normally again," she said. "I want to enjoy food without fear of being sick."

What is Achalasia?

Achalasia is a very rare condition, occurring in just 1 person per 100,000 population every year. It results from damage to the nerves within the esophagus, so the lower esophageal sphincter (LES) is unable to relax normally. This makes it impossible for food to pass into the stomach easily, resulting in regurgitation, dysphagia, and rapid weight loss.

Since achalasia is such an unusual condition, it is regularly misdiagnosed or mistaken for acid reflux, as with Elise. Some typical signs and symptoms include:

• Trouble swallowing (dysphagia)
• Bring-up of uneaten food
• Chest ache or pain
• Weight loss
• Spasms in the esophagus and resultant intense pain

There isn't a recognized cure for achalasia, but treatment via balloon dilation, Botox injections, or the POEM procedure can decrease symptoms and allow a better life.

Elise's experience serves to underscore the necessity for more widespread awareness of rare diseases such as achalasia. "I felt ignored for so long," she explained. "If doctors had listened to my symptoms sooner, I would not have spent years without diagnosis."

She wants to encourage others who have similar symptoms to get help and demand appropriate testing. "No one should have to wait years for a diagnosis," she said. "People need to know that this condition exists and that help is available."

Although Elise's experiences with achalasia have been painful and frustrating, she is optimistic that the POEM procedure will bring her the relief she so desperately desires. Meanwhile, she continues to adjust to living with the condition, doing her best to manage her symptoms.

"I just want to be able to eat without fear," she said. "I want to sit down for a meal with my friends and family, like everyone else."

As Covid-19 cases see a modest rise in several parts of India, leading scientists and public health experts are urging caution—not alarm. According to Dr. Vineeta Bal, former scientist at the National Institute of Immunology, the new variants currently in circulation are not posing a serious threat.

Speaking to IndiaToday.in, Dr. Bal emphasized that while mutations and sub-lineages of the virus are still emerging, the current situation is significantly different from the devastating Delta wave of 2021.

“This Is Not the Virus of 2021”

Recalling the chaos of 2021, Dr. Bal explained, “Back then, the virus was new to our immune systems, and the population had not been exposed to it before. That led to widespread severe illness and a major public health crisis.”

Today, however, the circumstances have changed drastically. India’s exposure to the virus—through both natural infections and widespread vaccination—has helped build community-level immunity. “Most people have either had Covid or received at least one vaccine dose, if not both. That has made a big difference in how the body responds to the virus now,” she said.

Covid-19 Now Behaving Like the Flu

Dr. Bal likened the virus’s current behavior to that of seasonal influenza. “We are now continuously managing new variants as they emerge. This doesn't mean the virus is gone or harmless, but the level of threat is quite low,” she told IndiaToday.in.

Most of the fatalities currently being reported are among elderly individuals or those with pre-existing conditions. Some are also patients still facing lingering health issues from past Covid infections.

“Be Alert, Not Anxious”

While the newer variants may be more transmissible, they are not causing large-scale severe disease. “A new variant can still be virulent, but because our population has some level of immunity, the impact is much lower,” said Dr. Bal.

She urged people to remain cautious, especially when it comes to high-risk groups such as senior citizens, people with chronic illnesses, and those who were severely affected in previous waves. However, she reassured that there’s no need for panic.

Living with an Endemic Virus

Experts now agree that Covid-19 is entering an endemic stage. “If your community built immunity during 2020 to 2022, either through vaccination or infection, it is unlikely that any new variant now will cause major illness or high fatality rates,” Dr. Bal said.

This view is echoed by other leading health experts. In an earlier interview with IndiaToday.in, former AIIMS chief Dr. Randeep Guleria explained that Covid is now endemic and will behave similarly to the flu—circulating in the population with occasional spikes.

Dr. Rajiv Bahl, Director General of the Indian Council of Medical Research (ICMR), also confirmed last week that the current rise in cases involves only mild symptoms. “People do not need to take any immediate action. They should follow normal precautions,” he stated.

The virus is still around—but the fear doesn't need to be. With vigilance, vaccines, and basic hygiene, India can manage this phase without falling into panic.

In an age of hyper-connectivity, concrete jungles, and climate anxiety, reconnecting with nature may be one of the simplest yet most powerful remedies for mental well-being. Green therapy—also known as ecotherapy, nature therapy, or Shinrin-yoku (forest bathing)—is gaining attention as an effective and accessible form of healing that uses nature to support emotional and physical health.

According to Dr. Mayanka Lodhi, Chief Pathologist at Redcliffe Labs, “The connection between nature and well-being is deeply rooted in science. When we spend time in green, clean spaces, our bodies respond positively—stress hormones drop, breathing slows, and mood improves. That’s why we must treat mental health and environmental health as interconnected.”

The Science Behind Green Therapy

Green therapy involves engaging with the natural world—through walks in the park, gardening, or simply listening to birdsong—to reduce stress and enhance mood. The benefits are both physical and psychological: decreased cortisol levels, lower blood pressure, reduced anxiety, and improved cognitive function.

A growing body of research backs this up. A 2021 study by Jimenez et al. found that regular exposure to green environments significantly lowers markers of stress such as heart rate and cortisol. “When you're surrounded by greenery, you're also surrounded by calm. The sights, smells, and sounds of nature activate our parasympathetic nervous system, which helps the body relax and recover,” Dr. Lodhi adds.

A Polluted Environment, A Polluted Mind?

This World Environment Day 2025, the focus is on plastic pollution. Often framed as a purely ecological issue, plastic waste has a quieter, more insidious effect—on mental health.

Urban spaces overflowing with plastic trash not only degrade ecosystems but also drain emotional resilience. Dr. Lodhi explains, “Imagine stepping into a park filled with wrappers and bottles—it disrupts the tranquility that nature is supposed to provide. Instead of peace, it may trigger helplessness or eco-anxiety, especially among the youth.”

She points out that mental wellness is compromised when we lose access to clean, natural environments. “Green therapy only works if the spaces we rely on for healing remain truly green—free from pollution and plastic.”

A Daily Walk Can Make a Difference

Even a short daily walk in a clean park or tree-lined street can work wonders. Studies have shown that just 10–15 minutes a day in natural settings can lead to:

• Reduced symptoms of depression
• Improved sleep quality
• Better focus and productivity
• A sense of groundedness and emotional clarity

Yet, these benefits are undermined in polluted environments. “When plastic takes over our parks and water bodies, it isn’t just a visual nuisance—it’s a psychological burden,” says Dr. Lodhi.

Redcliffe Labs through its Health for Earth initiative, the organization commits to holistic wellness by linking every test to a green action: planting one tree for every diagnostic test done. “We want people to understand that their health decisions also impact the planet,” says Dr. Lodhi.

Redcliffe is also pushing for a lower carbon footprint—saving over 3.76 crore A4 sheets through digital reports, which translates to saving 4,700 trees and preventing 188+ metric tons of CO₂ emissions.

“Whether it’s reducing plastic use, walking in green spaces, or joining a clean-up drive, each step we take for the Earth brings calm within us,” Dr. Lodhi reflects.

A Call to Action

As we mark World Environment Day, let’s reframe the fight against pollution as not just an ecological cause, but a mental health movement. Cleaner parks and greener neighborhoods can become sanctuaries for healing—if we care for them.

Because a healthier planet creates space for healthier minds. And in healing the Earth, we may also find a way to heal ourselves.

Stroke remains one of the leading causes of death and long-term disability in the United States, with substantial health and economic burdens. While traditional risk factors such as hypertension, diabetes, and smoking are well established, emerging research increasingly highlights the critical role of psychological factors, particularly chronic psychological distress, in stroke risk. A recent study published in journal Cureus, titled Chronic Stress and Stroke Among the Adult Population in the United States, sheds new light on this association by analyzing data from a large, representative sample of U.S. adults over more than a decade.

Why Was The Study Conducted?

The study aimed to examine the relationship between chronic psychological distress and stroke incidence among adults in the United States. Utilizing data from the National Health Interview Survey (NHIS), researchers analyzed responses from 284,497 individuals.

Psychological distress was measured using the K6 scale—a brief, standardized, and validated instrument known for its high specificity and reliability (Cronbach’s alpha 0.89)—making it ideal for large population screenings.

What Did The Study Find?

The analysis revealed that individuals experiencing psychological distress had more than twice the odds of having a stroke compared to those without distress, even after adjusting for demographic and cardiovascular risk factors. This 117% increased risk emphasizes psychological distress as a significant, potentially modifiable stroke risk factor.

These findings align closely with prior international studies. Research from Australia and the United Kingdom has similarly demonstrated that elevated psychological distress predicts higher stroke risk. For example, a large UK prospective cohort found significant links between distress and stroke incidence, while Australian studies identified distress as a predictor of fatal ischemic stroke, particularly in men. Another Australian population study confirmed associations between psychological distress and cardiovascular diseases, including stroke and diabetes, measured by similar validated tools.

Further supporting evidence comes from the Multi-Ethnic Study of Atherosclerosis (MESA), a U.S.-based longitudinal cohort, which showed that chronic stress, depression, hostility, and anger were linked to increased stroke or transient ischemic attack risk in adults free of clinical cardiovascular disease at baseline. Although MESA used different stress measures and focused on clinical stroke outcomes, its results complement the current study, underscoring the broader impact of chronic psychological distress on cerebrovascular health.

Role Of Obesity

An intriguing aspect of this study is its exploration of obesity’s interaction with psychological distress and stroke risk. Initially, obesity appeared to increase stroke risk in models unadjusted for cardiovascular factors. However, after adjusting for hypertension, diabetes, coronary heart disease, cholesterol levels, and smoking, obesity was associated with a 14% decreased stroke risk. This phenomenon echoes the “obesity paradox,” where obesity may confer protective effects in certain diseases, including heart failure and chronic kidney disease.

Previous work by the researchers has shown similar paradoxical trends in cardiovascular interventions and bone health, with notable differences across races and sexes. These findings challenge the simplistic view of obesity as universally harmful and support new obesity classifications that differentiate clinical risks. The World Obesity Federation and other scientific bodies have endorsed this nuanced understanding, emphasizing that not all obesity translates into worse health outcomes.

Public Health Implications and Future Directions

The study’s strengths include its large, nationally representative sample and use of the practical, validated K6 scale. The clear link between psychological distress and stroke risk suggests that addressing mental health could be a crucial strategy in stroke prevention efforts.

Given that stroke ranks fourth among causes of death in the U.S., and that stroke morbidity and healthcare costs are rising despite improved therapies, psychological distress stands out as an actionable target. The K6 tool’s ease of implementation in various clinical settings means healthcare providers can efficiently identify at-risk individuals and intervene.

The study highlights the importance of integrating mental health screening and management into cardiovascular risk reduction strategies. Addressing psychological distress offers a promising path to lower stroke incidence and improve overall public health outcomes.