I CONSIDER myself open-minded but I remember being taken aback when a new friend showed up at a café in Chicago, where I was a graduate student, wearing a “This is what depression looks like” T-shirt. My first thought was ‘what will people say’, followed immediately by ‘what is wrong with me, why do I think like my elders’ generation even when abroad?’ When I asked her about her T-shirt, she opened up about her depression and how the T-shirt was meant to reduce the stigma around it. I found myself able to relate, and, more importantly, share my stories without fear of judgement.

So I feel for all the men and women who consume content that doles out the worst advice, especially on mental health, because it keeps them in a vicious cycle of shame that prevents them from seeking professional help. While a lot more people — especially younger folks — have broken taboos around mental health, speak openly about seeing therapists, and advocate for more mental health facilities, we are far from accepting depression as a debilitating condition that can impact anyone.

Celebrities have played a valuable role in spreading awareness about depression, including in Pakistan, in a bid to break stigmas. Actors like Zara Noor Abbas and Mawra Hocane have been open with their struggles. Then there are … others.

Recently, the actor Resham was on a Ramazan show on PTV and said depression didn’t exist and defined it as being “doori [far[ from Allah”. She narrated how she was raised by her elder sister and whenever she missed her parents, she’d turn to God, and then said if anyone feels depressed, get on the prayer mat and cry.

The clergy has a role to play as mental health advocates.

She was ridiculed on social media for “backward, ignorant” views but given that PTV is arguably the largest network, her views reached more people, especially when coupled with the clip of her interview posted on social media.

Resham was echoing sentiments expressed by Maulana Tariq Jameel who said anxiety will increase the further you move away from faith. While integrating religious factors into treatments may improve the treatments’ efficacy, I think it’s dangerous for preachers to blame people for their health conditions as a result of not being religious enough.

The clergy has an important role to play as mental health advocates and can serve as channels for facilitating referrals to professionals. A 2022 study published in Journal of Religion in Health showed how an Islamic-based intervention in Malaysia “significantly reduced” levels of depression among the participants and saw “a substantial improvement in the patients’ general health”.

Stigma around mental health can hurt a person and their family, community and lead to devastating consequences. Imagine the public prejudice about mental health in Pakistan and how that can impact people into not seeking help. This can cause them to give up on pursuing goals — education, employment, enjoyment — because they don’t think themselves worthy. That public stigma can turn into self-stigma, ie, when a person internalises public prejudice and directs it towards themselves. It’s no surprise that a 2015 study published in the Pakistan Journal of Medical Sciences found that “women in comparison to men experience significantly greater levels of internalised stigma”. Women are twice as likely to be diagnosed with depression than men according to the Mayo Clinic. This country cannot afford subjective and regressive mental health literacy. It is not for the rich, though it may be viewed as a luxury only the rich can afford; however, I doubt anyone can afford it in this economic mess. Pakistan cut its health budget to Rs19.03 billion from Rs154.49bn in 2021/22. Its priorities have always been clear — they can’t seem to link its financial health with its citizens’ mental health.

Countries that spend on their people’s mental welfare stand to gain economically. Governments in France, Germany, Norway and Sweden spend 10 per cent or more on mental health. People have more hours to spend on leisure and personal care and incidentally these countries have 60pc or more green spaces. This is the stuff political leaders should aspire to, and I know how ridiculous it sounds given the state of the economy, but can we start to imagine such goals?

Do policymakers draft laws thinking of how they will impact people’s well-being? I’m especially thinking of housing policies or when homes are destroyed overnight with no thought to residents. What if leaders viewed mental health like a material resource, something that can help them prosper economically and socially? What if the state saw a citizen’s mental well-being as their ability to live to their potential and make positive contributions to their community? That shift in attitude may help build a nation ultimately able to find both economic and social success.

The writer researches newsroom culture.

Published in Dawn, April 5th, 2023