Some travelers who spend longer periods of time in India exhibit a curious condition: a spectrum of behavioral and psychological changes that can be all-consuming
In 1985, Régis Airault arrived in India to work as the resident doctor of psychology at the French consulate in Mumbai.
At the time, travelers from France, upon arriving in India, could visit the consulate to place their passport and return plane ticket into safe-keeping. Airault had the opportunity to speak to those travelers, often in their 20s or early 30s, soon after they landed in India. All were excited about their forthcoming travels.
But soon, Airault began noticing a curious condition in some of the French travelers, particularly among those who had spent longer periods of time in the country: a spectrum of behavioral and psychological changes that later became known as “India syndrome”. The condition has cousins around the world: religious tourists to Jerusalem are struck with a spontaneous psychosis upon visiting the city, certain that they are hearing God or in the presence of saints; visitors to Florence are physically overcome, even hallucinate, upon viewing the beauty of the city’s art.
In India, Airault would be dispatched to examine travelers who had lost their bearings, had become disoriented and confused, or had found themselves in manic and psychotic states. The contrast was shocking. “I would see them perfect when they arrive and after one month, I would see them totally unstable,” he recalls. Initially, what Airault observed was blamed solely on drug use, but many of the travelers were also exhibiting symptoms such as depression and isolation, stemming from a feeling of disorientation in an unfamiliar land or culture.
In rare cases, others were later diagnosed with acute psychosis, delirium and delusion. At its most powerful, India syndrome could be all-consuming, leading to a complete detachment from reality or an overwhelming disconnection from familiarity. Airault came to call that group “the travelers who were lost forever”.
Over the decade that followed, the French psychiatrist traveled back and forth between France and India researching and compiling notes and observations into a thesis, which he adapted into a book, published in 2000, called Fous de l’Inde – Crazy About India – which revolves around a central question: does India itself bring forth these transformations, or do people go there determined to be transformed?
“More than any other country,” he wrote about travelers from the west, **“**India has a way of stimulating the imagination and stirring intense aesthetic emotions which can at any moment plunge the traveler into utter anxiety. For this reason, our ‘experience’ of India can be somewhat ambivalent.” This depends on each person’s personal history, their ‘impulse to travel’ and past traumas which have been buried deep inside,” he wrote. “The subconscious has a way of bringing us face-to-face with them at certain times of our lives. Because India speaks to the unconscious: it provokes it, makes it boil and, sometimes, overflow. It brings forth, from the deep layers of our psyche, the buried.”
Airault distinguished the symptoms of India syndrome from common culture shock, the experience of travelers either feeling an intense connection to a new and different place or feeling an extreme rejection and disconnection from it. Culture shock often manifests within days of arriving; India syndrome, rather, typically emerges after weeks or months of residing in the country. He noted that many travelers arrive with some deep-rooted idea of what India is, previously held expectations of what India can offer – emotionally, physically or spiritually – and a hardened determination to realize that imagined experience: “The trip to India begins early, with the idea that we have made, conveyed by our culture, its cliches, its legends, its myths, but also by our childhood fed by marvelous tales and stories.”
He included dozens of examples of foreign travelers he observed or treated: one had burned his passport shortly after arriving and spent two months in prison suffering from anxiety attacks; one had been wandering around India, in good health and spirits, for five years even as his parents had presumed him dead; and another had traveled to the holy city of Varanasi and believed that the goddess Kali could hear his dreams and was speaking to him. Many of the cases were more benign: travelers arriving with an emotional or traumatic history that was suddenly brought to the surface and confronted, which resulted in a breakdown.
Much of what psychiatrists have noted as India syndrome, however, is rooted in an exaggerated and sometimes misplaced expectation for what travelers believe India might offer. They leave home expecting enlightenment at the pinnacle of their journey and stop at nothing in their pursuit.
Though India syndrome, like many of its cousins, is not universally recognized or officially accepted as a psychological diagnosis, the symptoms have become enough of a concern that insurance companies selling travel packages to India-bound tourists have been known to include clauses that void the coverage if the traveler has a psychiatric history or if he or she takes drugs.
Several embassies and consulates in India have permanent psychiatrists on staff to address and treat their nationals in distress. If they don’t, they contact a psychiatrist such as Sunil Mittal, who has built a career in part on diagnosing and treating the conditions that arise from India syndrome.
As the senior psychiatrist at the Cosmos Institute of Mental Health and Behavioural Sciences, Mittal sees approximately one foreign tourist every week in his office in New Delhi who would fall under the umbrella of India syndrome. The tourists arrive at the clinic through the recommendation of an embassy, in response to the concerned pleas of a family member, or as the result of an arrest made by police.
Mittal breaks down cases of India syndrome into two categories. The first occurs among those who arrive as simple tourists but bring with them some emotional or psychological issue or trauma relating to their family, their job, their relationships, or their past. “They come with a turmoil and they have a breakdown here,” Mittal explains. At the core of the person, he says, lies a vulnerability, a deep-rooted issue that he or she hopes to resolve.
The second group is made up of those who come to India determined to embark on some form of spiritual journey to seek higher meaning or realization. They visit holy centers and sites and immerse themselves in training and study of meditation or yoga. They often become enamored by yogis or gurus, or the juxtaposition between what is expected and reality, and seek an extreme break from their life back home.
“On the path of a spiritual quest, all the values that have been ingrained in someone are questioned,” Mittal says. “This can lead to a state of emptiness, a state of loss of direction, or a sudden feeling of exaltation – and then not knowing how to handle a situation.”
Though drug use is rarely the only spark, it is often an accelerant. Cannabis has been consumed in India for centuries in three forms. The most common is bhang, prepared with ground-up leaves and seeds that are mixed into a drink like a yogurt-based lassi. Ganga is the flowering buds of the cannabis plant, most often consumed by smoking. And charas, or hash, is produced by rubbing the sticky resin off the leaves and buds of the plant until it forms balls that are smoked in a straight clay pipe. Records of cannabis use in Ayurvedic medicine date back a millennium. But the plant most famously appears in Hindu mythology as a favorite of Shiva.