Psyche of the nation under stress

WHATEVER has been happening in Pakistan in recent months is presented in horrific terms by the western media. Not surprisingly, when I was planning my visit to Pakistan in July, my western colleagues at work cautioned me about the dangers I would encounter and the risks involved.

The international media has televised extensively human right violations, the murderous frenzy of the militants and the violence and terrorism that have been unleashed on the people of Pakistan. Unofficial estimates give a high ratio of people here who are exposed to extreme stress that is responsible for their psychological fragility.

When I landed here, the first impression I got was quite different. People appeared to be busy with their lives. They continued with extravagant feasts and merrymaking. Hotels and eating places were flooded. It was difficult to believe that an air of despondency prevailed.

However, on scratching the surface, you find the situation to be quite different. Many people expressed feelings of hopelessness and despair to me. Every second person I met spoke of a sleep problem and difficulty in concentrating and focused thinking. Many medical colleagues who are senior and have reached a high status in their careers spoke of escaping to a place that gave a greater sense of security.

A businessman reluctantly revealed that his nephew was kidnapped six weeks ago and that the matter had not been resolved for want of the demanded sum of ransom money. Another businessman developed clinical symptoms of severe depression after his son was kidnapped for the second time. He said this was a common problem and a number of businessmen felt threatened.

A general medical practitioner was looted at gunpoint in front of his patient and the incident led to his social withdrawal. As he approaches his clinic, he starts sweating, his heart thumps and he gets a full-blown panic attack. This has disabled him, and a large number of patients who were benefiting from his expertise have lost a good doctor.

The uncertain and volatile situation in Pakistan has caused great emotional turmoil for the people and has affected all sections in a variety of ways. According to behavioural scientists, when the situation goes beyond human control, one develops ‘learned helplessness’. This causes a person to leave everything to the mercy of fate — even to the extent of accepting doom.

However, a number of mental aberrations may also develop that result in several behavioural problems. What we see today in our society in terms of psychological repercussions is a state of denial, low frustration tolerance, aggressiveness and violence. There is an acute upsurge of physical ailments for which psychosomatic reasons cannot be excluded. Sudden deaths are often reported. Reactionary overeating and subsequent obesity is common. Disinhibition, an unacceptable social behaviour, manifests itself in communication, corruption and immoral acts of all kinds.

Economic disparity, inflation and the high cost of living have intensified the problem. As reported earlier by the World Bank, poverty, advancing age and violence are major indicators of increasing mental illness. Pakistan already has two factors in abundance.

Reportedly, depression which is a serious mental illness has a prevalence rate in the range of 10-44 per cent and this only includes the studied cases, and excludes a majority that does not go to any therapist at all. A local study conducted in Karachi, Lahore and Quetta reports the very high prevalence of household depression. It is said that 15 per cent of all depressives eventually commit suicide. Assuming that the reported magnitude of depression is true one can imagine the incidence of mortality associated with suicide.

Though genetics play a very important role in the etiology of mental illness, it is the environmental factors that are responsible for triggering a full-blown illness. Each life event has a threshold for initiating mental illness and when adverse events multiply and continue every day, it becomes practically impossible for the majority to remain sane.

Pakistan with all its current social adversities is at the brink of a psychological meltdown. Unfortunately, the psyche of those at the helm of affairs appears to be in the doldrums. On the one hand, the perpetrators of social adversities are in a wild frenzy. In order to satisfy their ego, they are playing havoc with the emotions of the nation and creating an environment that is highly non-conducive for mental wellbeing.

On the other hand, the nation as a victim is fast descending into a state of denial, negativism and violence, and succumbing to a variety of mental illnesses. Is there any ray of hope or light at the end of the tunnel?

Courtesy Daily Dawn Lahore/By Dr Amin A. Gadit