Mood swings, sleepless nights may be more than just stress.

Health experts say that instances of brain fog, disturbed sleep, or unexpected mood swings may be more than just stress. These can be early symptoms of neurological disorders, affecting the brain, spinal cord, and nerves.

A Lancet Global Health report (2021) said that in India neurological disorders have more than doubled since 1990. Experts say these illnesses include epilepsy, Parkinson’s disease, Alzheimer’s, stroke, and other neurodegenerative conditions, which impact their daily lives and ability to work.

“Many people don’t realize that symptoms like memory lapses, anxiety, lack of concentration, or disrupted sleep patterns can be early indicators,” says Dr. Madhukar Bhardwaj, Director & HOD-Neurology, Aakash Healthcare in Delhi. “These signs often get ignored as mental fatigue or age-related issues, especially in rural and semi-urban areas.”

India has over 10 to 12 million people living with epilepsy, according to the Global Burden of Disease Study 2019. “Around one-third of epilepsy patients don’t respond to regular medication,” notes Dr. Aakaar Kapoor, CEO, & Lead Medical Advisor, City X-Ray & Scan Clinic. “They require advanced diagnostics like MRI or PET scans, and surgery in some cases and these services that are rarely accessible outside big cities.”

The problem increases due to limited awareness and delayed diagnosis, which makes treatment harder. For instance, Parkinson’s disease often begins with non-motor symptoms such as constipation, sleep problems, or mood changes, years before tremors or stiffness appear, says Dr. Madhukar.

“Most of our rural patients come to us only after symptoms become severe,” says Dr. Neha Kapoor, Associate Director & Head-Neurology, Asian Hospital. “By then, the disease has progressed, and treatment becomes more complex.”

According to a 2023 review published in Science Direct, diagnostic tools for many neurological diseases in India are still under development. Biomarkers, which are measurable indicators of disease, are being studied for early detection of conditions like Alzheimer’s, Huntington’s disease, and ALS (a degenerative nerve condition), but their use is not yet widespread.

Another area of concern is stroke. “Many cases go undiagnosed in villages because patients are taken to hospitals too late,” Dr Rajas Deshpande, Consultant & Director – Neurology, Jupiter Hospital, Baner, Pune. “Some telemedicine initiatives, where specialists guide emergency care remotely are coming up, but are still not of the scale needed in a country like India. However, the bright side is that the Indian government’s Ayushman Bharat scheme includes coverage for some neurological disorders.”

“Mental health and neurological symptoms are still taboo in our society,” Dr Rajas adds. “Education and community outreach are very important as people avoid seeking help fearing others would label them as ‘mad’ or ‘possessed.’”

Highlighting the challenges, the Lancet article stresses the need for more epilepsy treatment centres and neurologists trained in diagnostics. While efforts are underway, the financial and human cost of ignoring early symptoms is too high, say neurologists.

“Even a basic awareness campaign on local TV or WhatsApp groups can make a difference,” says Dr. Neha. “People need to understand that forgetfulness, poor sleep, and sudden irritability are not always normal. It is better to consult a doctor in the initial stages itself.”