Indians retained the top spot in terms of being positive about their overall well-being and health, but are highly stressed due to work and financial issues and are uncomfortable seeking medical help for it, says a new survey.

The survey by Cigna TTK Health Insurance surveyed respondents in 23 countries, and tracked five key areas–physical health, family social, finance, and work. The survey was taken by 14,500 people.

In its fourth year of the survey, India showed a slight decline in physical, social and family wellness. As far as physical well-being is concerned, India dropped in terms of weight, nutrition management, and sleep-related challenges. And over 50% of Indians surveyed said they were not spending enough time with friends or did not have enough time for hobbies.

The survey also found that 89% of Indian respondents said they were suffering from stress compared to the global average of 86%, and a large number were not comfortable with seeking medical help.

“Nearly, 75% of respondents in India do not feel comfortable talking to a medical professional about their stress–cost is one of the biggest barriers to seeking professional help,” it says.

The stress levels are high in India compared with other developed and emerging countries including the U.S., U.K., Germany, France, China, Brazil and Indonesia.

The survey also says that one in eight people have serious trouble in dealing with stress, with millennials suffering more than other groups.

According to the World Health Organization (WHO), work-related stress is the response people may have when presented with work demands and pressures that are not matched to their knowledge and abilities and which challenge their ability to cope.

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