'Students collapse every day due to mental stress, studies are affected!'This news of Sudurpaschim Achham, published in Kantipur daily on January 28, attracted attention. Then my memory flashed back to that day about a decade and a half ago.

A team of psychiatrists including paediatricians, nurses, medical and nursing students reached a school in Sindhupalchok Helambu. The positive results brought by the psychosocial awareness program among school teachers, staff, students, parents and influential members of that community came before Jhaljha's eyes. 

Even at that time, there was a problem of sudden falling in the class of female students there. Even if nothing was done, the school had to be closed. This tendency could not be reduced even after the teachers and Bhadrabhaladmi of the society enacted many laws such as Pujaath, Rudrihom, wearing Dhamijankri. When the parents started holding the teachers responsible for this, some of them started threatening to change their children's schools.

After separate and collective discussions with students, teachers, staff, parents and dignitaries of the society, we revealed the possible cause of this problem . We adopted the psychological treatment method . We invited some students, parents, and teachers to our department at Dhulikhel Hospital and conducted a counseling session. It finally got us success . School is open again . Now it seems that the above-mentioned news has not come from that side .

About a decade ago, a similar incident happened in a school in Kavre's Baluwa and there was a news that there was tension in the school and the society. After receiving a request from the school side, we conducted a one-day psychosocial program of nature as mentioned above . We gave psychological counseling to the affected students and teachers, and tried to raise awareness about mental illnesses among other teachers and parents. After some time, the situation there also seemed to be under control. Now there is a decrease in such news from that side as well .

Due to lack of awareness and negative perception about mental health, psychology, psychiatry etc. And they take root in markets, villages, communities in the form of unnecessary commotion, shouting and panic. Such children are brought to our OPD only after spending time, effort and money on unnecessary and unnecessary procedures.

But happily, the situation is not the same as it was a decade ago. Even in the news of Achham mentioned at the beginning, this problem has been linked with mental stress . Psychosocial issues such as loneliness, domestic violence, and lack of study have been pointed out as possible causes. Therefore, the level of awareness about mental health is not as backward as it used to be.

How is this problem ?
Physical symptoms such as headaches, nausea, dizziness, dizziness, difficulty in breathing, and such problems, which are repeated from time to time, communicate fear and panic in the public . The physical cause of which cannot be detected but the symptoms are controlled in a short time . It spreads from one certain (influential) person to another and to another group through audio and visual means. It is known as 'mass hysteria' in the public tongue and networks. However, on scientific grounds, the name remains controversial. It is sometimes called 'Mass Sociogenic Illness' or 'Mass Psychogenic Illness'.

In Western countries (UK, South Africa), the fact that such problems appear in public places such as factory workers, soldiers, and airports has come to light. In our school students (mostly female students) it sometimes causes outbreaks. We have heard-seen-heard-seen-experienced the news that the school itself has been closed, Dhamijhankar has been called in the school, worship has been performed.

When such problems appear in medieval European countries, it can be read in the history of actions such as praying to demons, witches, etc. as the cause, physically torturing the victim to drive away witches, setting fire or putting a hole in the head . Now, in the 21st century, research is being done in the direction that environmental pollution, poisonous gas or war poisons can be the root of such problems. But the facts have not come to light. In view of the facts that have been proven by

studies, the root cause of this problem, which is mostly seen in women aged 7-30 years, can be unraveled only by exploring their psychosocial aspects . Due to discouragement mentality, physical and mental weakness, personal psychological problems and work load, family worries, social discrimination, poverty, pressure of studying etc., the psychological components in suppressed and subconscious state can be expressed in the form of these physical symptoms.

In the incident of the Sindhupalchok school mentioned, we tried to investigate on a psychological and psychiatric basis . It was found that the influential student of the school (9th grader and the school captain) fainted first, then her best friend, then another, and so on, not only the entire class but also the students of other classes were also affected . First of all, we sat and talked with the teacher about the fainting student. The fact that he was a few marks behind the second placed student (a student) in the recent examination came to light .

It cannot be deduced based on causality. However, psychological pain (reading, sexual, family or social) or stress that is common among students of the same age group in the society (class or school) can be one of the reasons. The above-mentioned physical symptoms affect one influential person first, then another, and then the whole class, school or society as a 'mass hysteria'.

How are the students affected by the school ? 
Most children in the age group of 7-17 stay in school most of the day. Since these symptoms spread from one to another, the school can be a potential area for these problems to emerge . The school's forced strict discipline environment, the difficulty of studying, and the fear of the teacher can also be factors . In some places, the fact that punishment has started such incidents has not come out. 

Is it because the repressed emotions in the female students erupt quickly or they have a tendency to show off to each other . Although at other times it remains hidden in the subconscious, it may be expressed anonymously at such times (when unpleasant physical symptoms appear in a close friend), mass hysteria is more common in female students. Similarly, in this age group, sexual organs develop more rapidly in teenagers and sexual curiosity increases, and intimacy also increases as they talk more about the same topic with each other . Especially, since this is the time when the menstrual cycle begins in teenage girls, the effect of the hormones that control it can also lead to the prevalence of such symptoms in girls. However, mass hysteria studies are still in the exploratory phase.

It should be a matter of shame for all of us that instead of taking steps to solve such problems that occur in the school itself, the school itself is closed. Similarly, this problem cannot be prevented by Dhamijankri or poojat. For this, the collective effort of teachers, parents, social and political workers, public health and other local administrative bodies and health workers is necessary.

What can teachers do?
From a psycho-social point of view, this problem spreads rapidly from one student to another and takes the form of an epidemic, so the students who show symptoms first should be moved to a safe place separately . After that, reasonable measures should be taken to minimize the fear that may arise in other students and teachers. Psychiatrists are skilled in this work, so they should be used to spread awareness among parents and teachers and eliminate confusion. Dialogue should be started as soon as possible for proper treatment of psychological problems in the student. If someone really has a physical problem (eg: leprosy), they should be treated with medical efforts. Media workers can also become assistants for the dissemination of public awareness materials .