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Sunday, Nov 11, 2001

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Under stress

The `working mother syndrome' must be recognised as a medical problem, writes DR. SUNIL JAIN.

THE timetable of a working mother makes one tired just by looking at it. A typical day would start at 6 a.m. and end after dinner time. The hard work can be compounded by the presence of demanding in-laws, children's illnesses and deadlines to be met at work. A woman in this situation always feels guilty that she is not doing enough for her children and her family, suffers from a feeling of inadequacy and is also found wanting by colleagues and bosses at work, and husband and in-laws at home. The children feel that their mother is not at home for them. Colleagues are usually unsympathetic. The husband often feels that he is being neglected. Classically, housework is not considered work at all, but just something a woman does, naturally; so it is rare that anybody in the family appreciates what the woman is doing for the home and understands why she is tired and irritable.

Working women are in a state of constant stress which manifests itself in symptoms like feeling weak, tired, irritable, having a headache, body ache, hyperacidity, pain in the abdomen and other gastro-intestinal problems. These complications take them to various doctors and specialists who usually prescribe symptomatic treatment without realising that the basic problem is excessive stress. As a result there is no lasting improvement. Clearly, the malady lies not in the body but in the stressed mind. The most common symptoms are:

Weakness and fatigue: Identifying stress as the problem behind weakness and fatigue can be difficult because any other physical disease may cause exactly the same symptoms. The doctor would usually prescribe non-specific treatment if no obvious cause is found, missing the actual problem.

Aches and pains: These symptoms may lead to the doctor asking the patient to get herself tested for a whole range of possible conditions without any clear diagnosis.

Headache: Any headache that continues for several days needs to be evaluated, but all headaches are not a sign of serious medical problems. Headaches resulting from tension are very common. Patients go from one doctor to another for eye-check ups and ENT examinations and may be finally referred to a neurologist.

Gastric problems: This group constitutes the most common illness resulting from stress. Hyperacidity, abdominal pain and frequent bowel movements are a possibility and patients try out several specialists without any abnormality being detected. Neither the patient nor the doctor recognise the problem. It is almost never focussed on when the patient is telling the doctor her medical history.

The treatment of all these ailments does not lie in mere symptom-targeting medication. This may cause transient improvement but does not cure the patient.

When nothing specific is found, many patients are labelled neurotic or hypochondriac, imagining themselves to be ill when there is no illness. They then get even less care from the family and the medical fraternity.

Medicines are not the answer to the problem. The real treatment is to reduce the burden on the working mother. Measures need to be taken to reduce the level of stress of working women. Here the family, especially the spouse, obviously plays the most crucial role in this. Helping the working woman out with domestic chores and sharing the burden of parenting can often do away with her hyperacidity.

Giving her time to relax, going out for a walk, meeting her friends, and forgetting the home for a while can be an enormous stress-reliever. The medical fraternity too should recognise the working mother syndrome and consider this aspect when treating her. If the real cause is detected quickly, cures can result not from medicine but from changes in lifestyle.

The writer is at the Gangaram Hospital, New Delhi.

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