For nearly two months now, Delhi has been breathing toxic air. What usually begins as a seasonal spike every winter has this year become a serious public health concern, with air pollution levels steadily worsening week after week. Thick smog has become a daily problem, reducing visibility and disrupting daily life, with people cutting back on morning walks, school travel and outdoor exercise.
While breathing problems, asthma attacks and heart risks are widely discussed, doctors are now warning about another hidden impact of polluted air, its effect on mental health.
Delhi woke up to yet another winter morning wrapped in dense smog as air quality remained firmly in the ‘severe’ category for the third consecutive day. The overall Air Quality Index (AQI) stood at 457 at 6 am, according to data from the Air Quality Early Warning System for Delhi. Several areas reported sharply reduced visibility, with residents complaining of eye irritation, headaches and a constant sense of discomfort.
But beyond these visible and immediate symptoms, mental health experts warn that prolonged exposure to polluted air can affect the brain, emotional and mental wellbeing.
How pollution affects mental health?
“Air pollution is not just a respiratory or environmental issue anymore. It is increasingly being recognised as a significant public mental health concern,” says Dr Neha Aggarwal, Consultant Psychiatrist at Adayu – A Fortis Network Hospital. She explains that growing scientific evidence shows polluted air can influence emotional wellbeing, stress levels, sleep quality and overall happiness.
Dr Aggarwal explains that air pollution affects mental health in several ways including biological, psychological and social. Fine particles like PM2.5 can enter the bloodstream, reach the brain and cause inflammation, which affects mood, focus and emotional control.
Dr Amitabh Saha, Associate Director and Clinical Administrator, Mental Health and Behavioural Sciences at Max Super Speciality Hospital, Vaishali, echoes similar concerns. “Long-term exposure to pollution can lead to the development or worsening of anxiety symptoms. Pollution particles can enter our bloodstream and cause inflammation in the brain,” he explains.
Anxiety linked to high pollution days
Mental health professionals say that anxiety is one of the most commonly reported psychological effects during periods of severe air pollution.
“Yes, air pollution can contribute to anxiety,” says Dr Aggarwal. “Multiple epidemiological studies show that exposure to high levels of pollutants such as PM2.5, nitrogen dioxide and ozone is associated with increased anxiety symptoms.”
She explains that polluted air interferes with efficient oxygen delivery in the body, often causing breathlessness, chest tightness, palpitations and dizziness. “These physical sensations activate the brain’s stress response system. When the body perceives difficulty in breathing, the brain interprets it as a threat, triggering anxiety or even panic-like symptoms,” she adds.
Dr Saha notes that people exposed to high pollution often report restlessness and irritability. “Individuals may have difficulty concentrating, feel uneasy or experience sudden mood changes on days when pollution levels are high,” he says.
Signs that anxiety may be linked to pollution include symptoms that intensify on high AQI days, increased fearfulness, racing thoughts, poor focus and avoidance of outdoor activities due to fear of worsening health symptoms.
Mood disorders beyond anxiety
Experts warn that the impact of pollution is not limited to anxiety alone. Long-term exposure to severe air pollution can contribute to a range of mood disorders.
“Chronic exposure has been linked with higher rates of depressive symptoms such as persistent low mood, fatigue, irritability, loss of interest in daily activities and feelings of hopelessness,” says Dr Aggarwal. In regions like Delhi, where winter smog is prolonged and sunlight is reduced, doctors also observe a rise in Seasonal Affective Disorder.
Dr Saha points out that pollution can worsen existing psychiatric conditions. “Mood disorders such as depression, emotional numbness and even bipolar disorder symptoms can intensify with long-term pollution exposure,” he says.
Certain groups are more vulnerable than others. “Children, the elderly and individuals already dealing with mental health issues are particularly susceptible,” Dr Saha adds. For children, ongoing exposure may affect emotional regulation and attention, while older adults may experience faster cognitive decline.
Cognitive fatigue and loss of motivation
One of the lesser-discussed effects of polluted air is its impact on cognition. According to Dr Saha, prolonged exposure to particulate matter like PM2.5 and even lower levels of PM10 can result in chronic inflammation and reduced oxygen delivery to the brain.
“The outcome may include difficulty concentrating, persistent fatigue, lack of emotional control and reduced motivation,” he explains. Many individuals report feeling mentally drained, unfocused and less productive during prolonged smog spells.
Dr Aggarwal adds that neuroinflammation caused by pollutants affects memory and information processing. “Studies have observed slower thinking, forgetfulness and reduced cognitive performance in people exposed to long-term pollution,” she says.
Sleep disruption and rising stress
Poor air quality also has a significant impact on sleep, which in turn worsens mental health. “People with persistent respiratory issues like asthma or allergic rhinitis caused by pollution may experience difficulty falling asleep, frequent awakenings, snoring or very light sleep,” says Dr Saha. These sleep disturbances increase the body’s production of cortisol, the primary stress hormone.
“As cortisol levels remain elevated, people feel more anxious, fatigued and irritable during the day,” he explains. “They may wake up feeling confused and emotionally unsettled even after a full night in bed.”
Dr Aggarwal adds that disturbed sleep weakens emotional resilience. “Poor sleep impairs emotional regulation and lowers stress tolerance, making individuals more vulnerable to anxiety and depressive symptoms,” she says.
Restricted lifestyles and emotional strain
Beyond biological effects, pollution also alters daily life. With outdoor activities restricted, people spend extended periods indoors, often with reduced physical movement and social interaction.
“This sense of confinement, isolation and loss of control can contribute to frustration, low mood and emotional distress,” says Dr Aggarwal. Lack of exercise and limited exposure to natural environments further compound mental health challenges.
Managing mental health during high pollution
While improving air quality requires systemic policy action, experts suggest steps individuals can take to protect their mental wellbeing.
“Reducing exposure is key,” says Dr Saha. He recommends using air purifiers indoors, limiting outdoor activity during severe AQI days, practising breathing techniques for relaxation, staying physically active indoors and maintaining a consistent daily routine.
Dr Aggarwal explains that awareness is important. “Recognising that pollution can be a trigger helps people address both physical and emotional symptoms early,” she says. Seeking professional help when anxiety, low mood or sleep problems persist is also crucial.