They were the perfect couple. Nikhil and Nivedita Aggarwal graduated from the Indian Institute of Management (IIM), Ahmedabad, two years ago and tied the knot. Everything matched — from the plum multinational jobs that each landed in Mumbai to the seven-figure salary. To their parents’ delight, even their caste matched.

Last year, Nikhil was rushed to hospital after he complained of chest pain. The doctors found his heart to be in perfect shape. They, in turn, referred him to a psychologist. After conducting a battery of tests, Dr Rajan Bhonsle, psychotherapist at Mumbai’s Heart to Heart Counselling Centre, diagnosed Nikhil as suffering from post-nuptial depression or PND.

Trouble between the couple began within weeks of the wedding. “Both partners had high pressure jobs. So they started throwing household responsibilities at each other,” says Bhonsle. Six months into the wedding, Nivedita was given a prestigious project to manage. She asked her husband to handle the home front till it got over. “Nikhil managed work, home and social commitments alone. He felt cheated, and depressed,” says Bhonsle. It took a year of therapy and medication to bring Nikhil out of the blues.

PND is a rapidly growing urban illness, say psychologists. Bhonsle claims that the number of PND patients who seek treatment at his counselling centre has doubled in the last five years. “The dynamics of marriage have changed. Now two career people get together and both bring their share of work stress to the marriage. This leads to a clash, depression and emotional breakdown,” explains Bhonsle. PND patients usually approach doctors with stress-induced physical symptoms like high blood pressure, angina, ulcers, insomnia and over-eating spells, adds Bhonsle.

PND strikes within the first two years of marriage. “A crisis stage occurs immediately after the high of the wedding. This is the time when couples face a new set of situations which they feel they can’t cope with,” says M.J. Thomas, consultant psychiatrist, Sagar Apollo Hospital, Bangalore.

One question: are adjustment problems between couples soon after marriage such a new phenomenon? “Relationship issues after marriage are not new. PND is just a new name that seems to be a catch phrase. I would call it an adjustment problem, rather than a new trend or disorder,” says Dr Bhupesh Velaskar, consultant at Guru Nanak Hospital, Mumbai, where he also lectures on psychology and mental health at its Institute of Nursing.

Mumbai-based psychologist Dr Sonya Mehta too guffaws when she hears the term PND. “There is no such thing in the DSM 4,” she says, referring to the current version of the Diagnostic and Statistical Manual of Mental Disorders, which is published by the American Psychological Association and used by psychologists and psychiatrists worldwide. “If at all there was such a disorder, we would just say it is stress-induced anxiety for some of the current problems that people come to us. What is new is not the disorder but the willingness of people to talk about these issues that bother them.”

But even if PND is yet to formally enter medical terminology, it is clearly on the rise. In any case, depression, in general, is on the rise in India. According to the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, one in every 15 adults in India suffers from depressive illnesses. The bug is spreading. A World Health Organisation (WHO) report predicts that depression will replace cardiac problems as the second most prevalent global illness by 2020.

Anindyo Sanyal, founder, Relations, a Calcutta-based marriage counselling centre, says the rise in the number of PND cases is proportionate to the rise in urban depression in India. “Modern day stress is the most significant reason for the rise in PND,” says Sanyal. “Today’s work culture is so time-consuming that married couples are left with no time to bond,” he adds.

Sanyal’s counselling centre got 1,800 cases of PND in 2006. In 2000, the centre got 250 cases. Sanyal finds that high-income individuals in the age group of 25 years and above are most prone to post-marital depression. “People with high incomes have more job stress and this stress creeps into marriage, causing depression,” he explains.

Like stress, loneliness also propels PND. Neha Mitra, 27, didn’t think twice when she agreed to marry Akhil, a debonair Calcutta-based gynaecologist. Marriage gave Mitra everything. “I had money, a luxurious life and a lot of time on my hands,” she says. But the euphoria of a deluxe lifestyle was short-lived. “My husband was out all day and returned home late and tired. I knew no one in the city. I became bored and resentful,” recalls Mitra.

At first, Mitra would cry into her pillow for hours. Then she became withdrawn and uncommunicative. Seven months into their marriage, Akhil took his wife to a psychiatrist. Neha was diagnosed as suffering from PND.

A study by a website, Indianpsychiatry.com, found that depression rates were higher among young, married women in urban India. “A common reason for this is the excess amount of household and child bearing stress that marriage results in,” says Zia Nadeem, consultant in rehabilitation psychiatry, St John’s Hospital, Livingston, Scotland, and convener, www.indianpsychiatry.com.

But Dr Ali Khwaja, founder, Banjara Academy, a Bangalore-based counselling centre, finds that PND has no gender bias. He says he’s seen a 500 per cent increase in PND patients coming to his centre for counselling in the last three years. “Ninety per cent of my patients work in the information technology (IT) and other sunrise sectors, where job pressures are high,” says Khwaja.

Khwaja remembers being taken aback when a 30-year-old software professional, Vidya Nair, visited him on the day of her first wedding anniversary. “She said she felt more depressed than usual on that day,” remembers Khwaja. Despite living together, Vidya and her busy IT professional husband — who worked in a city-based multinational — met only on weekends. During weekdays, they communicated — if at all — over the phone and in Internet chat rooms. “Vidya said she felt emotionally stranded. This is not what she had pictured marriage to be,” says Khwaja.

Indeed, the rules of matrimony are changing. Psychiatrist Thomas says young professionals are increasingly seeking social and emotional support at the workplace — rather than from their spouse. “This leaves no scope for bonding and adjustment between couples,” says Thomas.

In Delhi, one in every five clients who walks into psychiatrist Neeru Kanwar’s clinic comes for PND counselling. “As most urban couples get married at a late age, they have greater expectations and lower adjustment thresholds. Add to this the high stress of modern life and it’s a sure-fire recipe for conflict between couples,” she says.

Nor is PND just a big city phenomenon. Dr Ajay Gill was running a healthy general medicine practice in Chandigarh till three years back. Then he began getting a string of newly-wed female patients who came with vague complaints of headache, acidity, skin problems and lethargy. “I found that all their physical problems had psychological roots. The women suffered from anxiety and depression,” says Gill.

Gill enrolled with the Indian Association of Family Therapy and started Chandigarh’s first marriage counselling centre — Happy Couples India — two years ago. It’s not happy news, but Gill says his practice is flourishing.

Kerala tops the charts in the number of divorce cases filed before any state’s family court. Most cases are filed by young couples who’ve been through the cycle of marital conflict, depression and finally divorce, says Dr C.J. John, chief psychiatrist, Medical Trust Hospital, Kochi.

“The number of young women who seek marital counselling and divorce has shot up dramatically in Kerala. I see five new patients every day,” says John. The issues that trouble young couples range from sharing household chores, adjusting to a new way of life to even deciding who gets to drive the bigger of the two family cars. “Many young couples today have huge egos,” says John.

Sociologists believe the most common cause for tension between spouses is demanding professions. “Professional demands make it impossible for couples to spend time together. Both partners have work tensions which they take out on each other,” says sociologist Prasanta Ray.

Add to this the rapidly decreasing tolerance levels in urban society. “Tolerance levels are going down, whether on the road, in movie hall queues or in marriage. Small marital adjustment issues become full-blown reasons for depression and divorce,” says counsellor Ajay Gill.

Young couples get depressed over just about anything. In Mumbai, psychiatrist Harish Shetty recalls the case of an architect, Nidhi Mehta, who suffered an emotional breakdown within months of her marriage because she didn’t have the freedom to wear what she wanted. “Nidhi was required to wear traditional Indian clothes at her husband’s house. She also had to cook breakfast every morning,” recalls Shetty.

“Girls are expected to change overnight after marriage,” explains Shetty. “This doesn’t work with today’s women. They aren’t ready for sudden shifts in equations,” he adds.

Also, with women becoming economically independent, neither partner is ready to bow down after taking vows. “Women want their space and self-identity intact after marriage. Neither partner is ready to compromise,” says Aruna Broota, clinical psychologist and professor, department of psychology, University of Delhi.

Clearly, for many young couples, a big fat Indian wedding is the beginning of a long rough ride into depression and unhappiness.