Tuberculosis (TB) remains a serious global health crisis, impacting millions of individuals every year. While a lot of focus is placed on the physical symptoms of the condition, its psychological impact is often overlooked. Not only do patients experience the direct consequences of the condition but they also suffer greatly from psychological issues such as stress, anxiety, and depression. Research has shown that TB patients often have higher levels of psychological distress caused by social stigma, long treatment durations, economic burdens, and separation.Dr. Shweta Bansal, Sr. Consultant & Unit Head - Respiratory Disease & Sleep Medicine, points out that psychological distress can change patterns of gene expression, resulting in immune responses that exacerbate TB symptoms and interfere with treatment outcomes. Stress and anxiety affect TB susceptibility and progression, and therefore mental health interventions are a critical part of TB care. Without incorporating mental health support into TB treatment, patient adherence decreases, and the risk of complications, such as drug resistance, increases.Neglected Symptoms of Drug-Resistant TBA growing worry is the increased prevalence of drug-resistant TB (DR-TB) in young adults. Most in this age bracket view work and lifestyle needs above their health, and as such, early TB symptoms are ignored. "Young adults work long hours, ignoring symptoms of sickness in the name of hustle culture," opines Dr. Bansal. Symptoms of common DR-TB, including chronic cough, low-grade fever, tiredness, and loss of weight, are usually attributed to stress or fatigue. The fact that the symptoms are delayed allows the infection to advance, making treatment more difficult and elevating the risk of transmission.Early diagnosis is important to avert DR-TB from gaining more ground among younger generations. Yet, the stigma of TB tends to prevent young adults from visiting doctors, further worsening the situation. Dr. Bansal opines, "Adolescents need to recognize unusual health changes and see doctors early. Health precedes continuous work in avoiding severe complications of TB."Environmental and Lifestyle Factors Increasing DR-TB RiskAlthough tobacco smoking—cigarettes, e-cigarettes, and vaping—is a recognized risk factor for TB, there are other environmental and lifestyle factors that increase susceptibility substantially. According to Dr. Bansal, air pollution, excessive stress, and poor nutrition weaken immunity and make young adults susceptible to TB infection.Also, the abuse of antibiotics contributes to DR-TB emergence. "Taking antibiotics repeatedly for everyday respiratory infection may lead to antibiotic resistance, and TB becomes harder to treat," she clarifies. Poor living conditions with high-density populations, like group apartments or hostels, also increase the risk of exposure to TB germs. These combined circumstances contribute to an environment where TB germs have a chance to survive, making prevention and early detection more pressing.Danger of Misdiagnosed TB and the Role of AwarenessOne major obstacle to the control of TB is misdiagnosis. TB cases often go undiagnosed as the symptoms are similar to usual respiratory infections, allergies, or flu during seasonal times. Chronic cough, low fever, and persistent fatigue are often brushed off as minor illness. Physical signs, like lumps in the neck or under the arm—TB's possible early warning signs—are often overlooked or attributed to other infections, warns Dr. Bansal.Misdiagnosis leads to delayed treatment, with TB developing into drug-resistant strains. "Young adults do not usually consider TB as a risk, so they may not seek early testing. This delay allows for drug-resistant TB to progress, making it difficult to treat," reports Dr. Bansal. Awareness, early screening, and education regarding symptoms of night sweats and unexplained weight loss are all key to tackling this increasing epidemic.Mental Health Cost of Drug-Resistant TBIn addition to the physical hardship, drug-resistant TB has a serious psychological cost. The long and frequently painful treatment process—months of aggressive antibiotic therapy—can be extremely emotionally taxing. Depression and anxiety are common among TB patients, compounded by social isolation and economic hardship.Depression, a global mental health condition, is suffered by about 4.4% of the world's population. The South-East Asia region carries a heavy burden, and India alone has about 18% of the world's depression cases. Dr. Bansal points out that "depression can arise from interruptions in daily life, social isolation, disease stigma, and TB symptoms. In extreme cases, depression can lead to suicidal thoughts and a poor quality of life."Coping strategies are essential in addressing the psychological burden of DR-TB. Support systems, psychotherapy, and lifestyle changes can assist patients in coping with the emotional burden of their condition. Dr. Bansal promotes the incorporation of mental health interventions into TB treatment, citing that "it is imperative that mental health treatments be integrated into TB care in conjunction with initiatives to lessen stigma and enhance social support."The quiet outbreak of drug-resistant TB among young adults necessitates immediate intervention. Increased awareness, early diagnosis, and treatment strategy in full range—including mental care—are crucial for stemming this mounting health threat. While hustle culture keeps on motivating young people to ignore their wellbeing, solving the problem of TB in this population calls for an all-round plan that puts prime importance on education, preventive management, and sturdy healthcare system.Finally, fighting DR-TB requires changing public attitudes. TB is not just an old disease—a disease of the past—it is still an ongoing and urgent international challenge. Only by taking early measures, raising awareness at the lifestyle level, and adopting comprehensive healthcare measures can we ensure that DR-TB does not become an even more dangerous public health challenge.Dr. Shweta Bansal is a Sr. Consultant & Unit Head of Respiratory Disease & Sleep Medicine (Unit II) at Artemis Hospitals in India.