In November 2024, Dr. Maria emerged from her supervisor’s office in a daze. As she walked through the hospital’s empty corridors, she could barely register where she was going.
By the time she arrived in the empty parking lot, she hardly had any strength left in her legs. Her knees buckled, and she collapsed.
“All I knew in that moment was that I couldn’t breathe. I could feel the pain in my chest,” said Dr. Maria, who asked to be identified by a single name.
“I know that saying no to my supervisor was what triggered it all. But whatever happened after I left her office is something I can never forget or undo,” she told UCA News.
For a very long time, the 24-year-old didn’t realize it was a panic attack — her first.
“It set off a chain reaction, triggering a cycle of panic attacks that I wasn’t even able to recognize until July 2025,” she recalled.
Lack of awareness
Dr. Maria’s inability to recognize her condition despite being a healthcare practitioner reflects the serious lack of awareness and understanding surrounding mental health issues in Pakistan.
Its first nationally representative mental health survey, published in September, found that 32.3 percent of adults were living with a diagnosable mental or behavioral disorder, while 37.9 percent had experienced one during their lifetime.
The survey, conducted by researchers representing the Pakistan Psychiatric Society (PPS) and involving 17,773 adults across the country’s four provinces, also found that neurotic and stress-related disorders were the most prevalent category, affecting 24.5 percent of adults.
A similar difficulty in understanding emotional distress was experienced by Sehar Fazal. Growing up, she couldn’t understand why her environment impacted her so deeply.
“At 28, I still experience phases of sadness, anxiety and emotional overwhelm,” she told UCA News.
She became aware of the patterns in her emotional responses and how past experiences reflected in them through research on the internet.
“Family expectations regarding lifestyle, education, finances, marriage and relationships have a significant impact on mental health, especially when they do not align with one’s personal aspirations,” she said.
Limited job opportunities and financial instability contributed to uncertainty and anxiety.
“The fear of disappointing one’s family added to emotional distress,” Fazal added.
The national survey identified an association between psychiatric morbidity and socioeconomic circumstances.
It found that unemployment was associated with a higher likelihood of mental and behavioral disorders, while higher levels of education and income were associated with a lower likelihood.
Fear of being labeled
Beyond socioeconomic pressures, stigma can also make it difficult for people to speak openly about their mental health struggles.
“People with mental illness in Pakistan usually try to hide or mask it,” according to Syed Tabraiz Bukhari, a clinical psychologist.
“They might disclose their struggles to close friends, but they are less likely to share them with their families because of the stigma attached to mental illness and the fear of being labeled.”
There is the fear that disclosing difficulties in workplaces or educational institutions might lead others to consider them incompetent, he added.
Bukhari also highlighted the financial barriers to seeking professional help, noting that an experienced psychologist may charge US$11 to US$18 per session, which many people cannot afford.
The fear of being misunderstood or dismissed engulfed a 24-year-old nurse from Lahore, who requested anonymity.
“Growing up, I’ve always felt like I’m a misfit. Some days everything feels normal, sometimes even better than normal, but other days are suffocating,” she said.
It felt as if she had a deadly chronic diagnosis at birth, and “no matter where I go or what I do, I can never escape it.”
But the worst thing was not having anyone to talk to and the feeling that everyone else around was normal.
“Why make your problem everyone else’s problem?”
She tried talking to her parents and a few others who she thought could help.
“But people around me seemed to think that if my health problems weren’t physical, they weren’t problems at all,” she recalled.
Faith, community can help
Unlike her, 27-year-old Kashan Gill felt himself becoming emotionally detached from situations as he grew older.
He had a different problem: wanting to seek professional help but not knowing how to express what he was experiencing.
“My ability to feel anything just disappeared, but sometimes, I feel an enormous amount of rage within me,” he told UCA News.
This difficulty of expressing emotional distress and finding support raises questions about how communities respond to mental health struggles, according to Reverend Sajid Azeem, a pastor and clinical psychologist, who leads Gracewell, a mental health initiative of Grace Believers Society Pakistan.
A recent study of Christian adults in Lahore, Karachi and Faisalabad found higher levels of perceived stigma were associated with greater psychological stress, he told UCA News.
The study also identified faith and church communities as sources of emotional support, although some participants reported spiritual struggles.
“Faith can be a source of hope, meaning, belonging, and practical support,” Azeem said. “But spiritual care should never shame people, blame them for their distress, or suggest that prayer alone replaces professional help.”
The pastor-psychologist stressed greater mental-health awareness that leads to practical care.
“Every person should be able to speak about distress without fear of shame, and every community should have a path toward support,” Azeem added.
For Dr. Maria, the panic attacks continued while she worked at the hospital.
Things began to improve after she left her job.
“I have started recognizing my patterns. I was advised to take medication for anxiety, but I’m trying to manage it without medication,” she added.
