By Anjum Mehmood Siddiqui
Consultant Clinical Psychologist | Psychotherapist | Personality Analyst
Islamabad • Rawalpindi • Pakistan • Online
Mental health is not simply about whether someone has a psychological disorder. It is about how we think, feel, relate, cope, function, and experience our lives.
Mental health is becoming one of the most important public-health conversations of our time. Yet despite increasing awareness, many people still struggle silently with anxiety, depression, emotional overwhelm, relationship difficulties, trauma, loneliness, low self-worth, and persistent stress.
Sometimes the difficulty is obvious.
Sometimes it is hidden behind a successful career, a family life, academic achievement, or a smile.
A person may be functioning on the outside while internally feeling exhausted, disconnected, frightened, angry, or overwhelmed.
This is why understanding mental health matters.
Mental Health Is a Global Issue
According to the World Health Organization’s latest global estimates, more than one billion people worldwide live with a mental health condition. WHO’s 2025 report also highlights that mental-health conditions remain widespread, significantly undertreated, and under-resourced.
Earlier WHO estimates found that in 2021, approximately 1.1 billion people—or nearly 1 in 7 people worldwide—were living with a mental disorder. Anxiety and depressive disorders were among the most common.
These numbers represent more than statistics.
They represent people trying to:
- Sleep despite racing thoughts
- Manage overwhelming emotions
- Maintain relationships
- Work or study while struggling internally
- Recover from difficult experiences
- Understand themselves
- Feel confident again
- Find meaning and connection
Mental health affects people across ages, cultures, professions, and income levels.
It is not a weakness, a character flaw, or something that happens only to certain types of people.
What Is Mental Health?
The World Health Organization describes mental health as a state of mental wellbeing that enables people to cope with life’s stresses, develop their abilities, learn and work effectively, and contribute to their communities. WHO also emphasizes that mental health exists on a continuum and can be influenced by individual, family, community, and broader social factors.
This is important because mental health isn’t simply:
Healthy vs. Ill
There can be many experiences in between.
You may be functioning reasonably well while experiencing:
- Chronic stress
- Relationship difficulties
- Low confidence
- Emotional exhaustion
- Persistent worry
- Difficulty setting boundaries
- Unresolved grief
- Problems regulating anger
- Repeated unhealthy patterns
These experiences deserve attention even when they don’t necessarily indicate a diagnosable mental disorder.
Mental Health in Pakistan
Pakistan faces significant mental-health challenges, but obtaining precise, current national prevalence estimates remains difficult.
WHO has specifically noted that mental-health data are not routinely collected in Pakistan’s national health information systems, while stigma, limited resources, and inadequate services remain important barriers.
This means we should be careful with statements such as:
“X% of every Pakistani suffers from mental illness.”
There is no single contemporary national figure that can accurately represent the entire population.
However, available research shows that mental-health difficulties are substantial.
A national mental-health survey conducted in Punjab found current mental morbidity of 13.42% and lifetime mental morbidity of 17.94% among adults in its sample. The researchers also found differences associated with factors including income and rural residence.
Earlier Pakistani research has also reported considerable levels of anxiety and depressive symptoms, although estimates vary substantially depending on the population, methodology, screening instrument, and setting.
Why do estimates vary?
Because measuring mental health is complex.
A study of university students, for example, cannot be used to describe the entire Pakistani population.
Likewise, a survey conducted during COVID-19 cannot be treated as a normal-period national prevalence estimate.
Good mental-health information requires context, methodology, and careful interpretation.
Pakistan’s Mental-Health Treatment Gap
One of the biggest challenges is not simply the number of people experiencing psychological difficulties.
It is the number of people who cannot access appropriate care.
WHO’s Pakistan reporting highlights limited resources, stigma, inadequate data systems, and insufficient mental-health services. WHO has also reported historically low psychiatrist availability in Pakistan compared with many other settings.
This creates an important distinction:
Mental-health need and access to mental-health care are not the same thing.
Someone may recognize that they need help but still hesitate because of:
- Social stigma
- Fear of being judged
- Cost
- Lack of awareness
- Limited availability of qualified professionals
- Family attitudes
- Geographic barriers
- Concerns about confidentiality
- Uncertainty about what therapy actually involves
This is one reason mental-health education matters.
Anxiety: When Worry Becomes Difficult to Control
- Everyone experiences anxiety.
- Before an examination.
- Before an important meeting.
- Before making a major decision.
Anxiety becomes a clinical concern when fear or worry becomes excessive, persistent, difficult to control, and begins interfering with everyday life.
WHO estimates that 359 million people worldwide were living with an anxiety disorder in 2021, making anxiety disorders the most common category of mental disorder globally. WHO also reports that only around 27.6% of people needing treatment for anxiety disorders receive treatment.
Anxiety may involve:
- Constant worrying
- Restlessness
- Irritability
- Difficulty concentrating
- Sleep problems
- Racing thoughts
- Muscle tension
- Physical symptoms
- Avoidance
- Fear of future situations
Sometimes the mind is trying to protect you from danger that isn’t actually present.
Therapy can help a person understand these patterns and develop healthier responses.
Depression Is More Than Feeling Sad
Everyone experiences sadness.
Depression is different.
WHO describes depression as involving persistent depressed mood or loss of interest or pleasure that can affect many areas of life. Current WHO estimates indicate that approximately 5.7% of adults globally experience depression, although prevalence differs between populations and countries.
Depression may affect:
- Motivation
- Sleep
- Appetite
- Concentration
- Relationships
- Work
- Studies
- Self-worth
- Energy
- Interest in previously enjoyable activities
A person experiencing depression may not always look sad.
Sometimes depression looks like:
“I don’t care anymore.”
“I am tired all the time.”
“I just want everyone to leave me alone.”
“I don’t feel like myself.”
These experiences deserve professional attention when they are persistent or significantly affecting life.
Why People Sometimes Hide Their Mental Health Struggles
In many cultures, including South Asian communities, psychological difficulties can be misunderstood.
Someone may be told:
“Just be strong.”
“Everyone has problems.”
“Don’t think so much.”
“You have everything—what are you worried about?”
But emotional pain doesn’t disappear simply because someone else cannot see it.
Mental-health awareness means creating space for people to say:
“I’m struggling.”
without immediately being judged.
Your Thoughts Can Influence Your Emotions
One of the foundations of Cognitive Behavioral Therapy (CBT) is understanding the relationship between thoughts, emotions, and behaviors.
Imagine receiving a short message from someone you care about:
“We need to talk.”
One person may think:
“I must have done something wrong.”
They may feel anxious and repeatedly message the person.
Another may think:
“Maybe something important happened.”
- They may feel concerned but wait for the conversation.
- The situation is the same.
- The interpretation is different.
- The emotional and behavioral response can therefore be different.
CBT helps people identify such patterns and develop more balanced and effective ways of responding.
Emotional Regulation: You Don’t Have to Suppress Your Feelings
A common misunderstanding is that emotional control means not feeling emotions.
It doesn’t.
Emotional regulation means learning to recognize and respond to emotions more effectively.
Instead of:
Trigger → Intense emotion → Immediate reaction → Regret
we can work toward:
Trigger → Awareness → Pause → Understanding → Response
DBT-informed skills, for example, include approaches related to mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness.
The goal isn’t to become emotionless.
The goal is to create enough space to choose your response.
Why Do We Repeat the Same Relationship Patterns?
Have you ever wondered:
“Why do I keep choosing the same type of relationship?”
“Why do I become anxious when someone becomes distant?”
“Why do I shut down whenever someone gets emotionally close?”
“Why do small disagreements become huge arguments?”
Relationships are influenced by many factors, including communication, personality, attachment, emotional needs, expectations, previous experiences, and coping patterns.
Understanding these patterns can help move the conversation from:
“Who is to blame?”
to:
“What pattern are we caught in?”
This is an important focus of relationship-focused psychotherapy.
Childhood Experiences and the Adult Emotional World
Our early experiences can influence how we understand:
- Safety
- Trust
- Rejection
- Love
- Boundaries
- Self-worth
- Emotional expression
- Relationships
This does not mean every adult difficulty is caused by childhood.
Human behavior is much more complex than that.
However, exploring earlier experiences can sometimes help people understand why certain situations trigger unusually strong emotional responses.
This is where carefully conducted inner-child-focused exploration may be useful as part of broader psychological work.
Shadow Work: Understanding the Parts We Avoid
There are aspects of ourselves we may prefer not to acknowledge:
- Jealousy.
- Anger.
- Fear.
- Shame.
- Insecurity.
- Need for approval.
- Vulnerability.
- Resentment.
Shadow-work-informed exploration can be used as a reflective approach to increase awareness of these less-acknowledged aspects of ourselves.
It should not be confused with a standalone diagnosis or presented as a universal treatment for mental disorders.