Despite growing global conversations about mental health, in Pakistan, the topic remains enveloped in layers of shame, fear, and misinformation. Stigma leads to delayed treatment, underreporting, and silent suffering. As an Integrative Mental Health Coach based in Pakistan, I’ve witnessed this firsthand—and experienced it myself. In a culture where acknowledging emotions feels radical, seeking help can be a solitary journey.
This article explores the roots of mental health stigma in Pakistan, the gender-specific burdens it imposes, and how culturally informed coaching and holistic practices can be part of the solution.
A Cultural Legacy of Silence
In Pakistan, mental illness is often perceived as a moral failing, spiritual weakness, or punishment. Societal norms emphasize family reputation, religious faith, and community perception. According to a study by Savaira.org, over 60% of respondents believe mental health conditions are exaggerated or not real. Even discussing emotional struggles with close family is uncommon.
Consequently, individuals suffering from anxiety, depression, or trauma often go untreated for years. Seeking therapy is viewed as a last resort, if considered at all. Emotional pain is something to be “toughed out” in silence.
Gendered Burdens and Emotional Suppression
For Pakistani women, stigma is intertwined with expectations to be self-sacrificing and emotionally resilient. A mother, wife, or daughter admitting to feeling overwhelmed may be told, “Be grateful,” “Pray more,” or “It’s just hormones.” Seeking therapy could result in being labeled unstable or unfit for marriage.
For men, the crisis is equally dire but masked. Boys are raised with mardangi—an ideal of masculinity rooted in stoicism and emotional suppression. Vulnerability is equated with weakness. Many internalize their emotions, leading to aggression, substance use, or psychosomatic illness. Suicide among men is often underreported due to cultural denial.
Barriers to Access and Support
In rural Pakistan, mental health infrastructure is almost nonexistent. The only available support may be a local religious leader, who may not be trauma-informed or trained. In urban areas, affordability, social stigma, and a lack of culturally competent professionals limit access.
The WHO’s Mental Health Atlas 2020 reports that Pakistan has only 0.57 psychiatrists and 1. 4 total mental health workers per 100,000 people, far below global standards.
📖 WHO Country Profile – Pakistan
Intergenerational Trauma and Silence
Mental health stigma in Pakistan is rooted in collective history. The trauma of Partition, colonialism, and generational grief has left psychological wounds that families have never learned to process. Emotional repression is often passed down.
A 2024 Springer study identifies structural barriers,like poor implementation, under-trained professionals, and low public trust, as major challenges to mental health reform.
📖 Springer Study on Mental Health in Pakistan
Understanding Mental Health Support in Pakistan
A widespread issue is the public's confusion about roles in mental health care:
- Psychiatrists: Medical doctors who prescribe medication.
- Psychologists: Offer therapy but usually don’t prescribe.
- Counselors: Provide guidance for specific life issues.
- Coaches: Focus on personal growth, lifestyle changes, and early intervention.
Due to lack of awareness, many go straight to psychiatrists, receive medication, and remain on it for years, often without ever addressing the root cause. While medication is necessary for some, many conditions could be managed holistically through coaching, cognitive-behavioral techniques, and lifestyle changes, especially if caught early.
Integrative Mental Health Coaching as a Preventative Approach
Integrative Mental Health Coaching (IMHC) offers a culturally sensitive, non-clinical space to explore emotional well-being. It focuses on the whole person (mind, body, and spirit) through tools like:
- Psychoeducation to normalize emotional struggles
- Trauma-informed care rooted in cultural history
- Mind-body practices like breathwork, journaling, and nutrition
- Gender-aware coaching approaches that reflect lived experiences
One of my first clients was a young woman with undiagnosed postpartum depression. She’d never spoken of it—not even to her husband—for fear of being seen as a bad mother. Our sessions began with silence. Over time, through journaling and breathwork, she opened up. Months later, she said, “I didn’t know I was allowed to feel this way.” That moment stays with me.
In my practice, I’ve seen transformation happen when people feel safe and understood in their cultural context. A teenage boy practicing breathwork for anxiety. A mother expressing needs she never voiced aloud. This is the power of early, holistic support.
Integrative Mental Health Coaching helps:
- Normalize emotions without pathologizing them
- Use relatable metaphors and local context
- Engage families and communities in healing
- Prevent escalation into severe mental health crises
Mental Health and the Entrepreneurial Landscape in Pakistan
Pakistan's entrepreneurial ecosystem is burgeoning, driven by a youthful population and increasing digital connectivity. However, the pressures of entrepreneurship; financial instability, societal expectations, and lack of support, can exacerbate mental health issues.
A study published in Frontiers in Psychiatry found that 84% of social entrepreneurs in Pakistan reported symptoms of depression, and 80% reported anxiety during the COVID-19 pandemic. Limited resources and changes in customer behavior were significant stressors.
📖 Mental Health Survey of Social Entrepreneurs During COVID-19Frontiers+1PMC+1
Moreover, discussions at the Institute of Business Administration (IBA) highlighted the emotional toll of leadership and the importance of self-awareness and vulnerability in building resilient institutions.
Given that a significant portion of Pakistan's population is under 30, addressing mental health in the entrepreneurial sector is not just beneficial, it's imperative for sustainable economic growth.
A Way Forward
Breaking the silence around mental health in Pakistan requires time, compassion, and cultural humility. Change must come from within, through education, local leadership, and a redefinition of strength. True resilience lies not in suppression, but in integration and healing.
By creating shame-free, culturally resonant spaces, integrative mental health coaches can help communities not just cope, but thrive.
Author Bio
Cynia Ejaz, (a recent graduate of our Certified Integrative Mental Health Coach Training Program), is a licensed Integrative Mental Health Coach, an entrepreneur, marketer and corporate innovation leader based in Pakistan. With a background in business and wellness, she blends coaching psychology, CBT techniques, corporate mental health training and trauma-informed practices to help clients navigate anxiety, depression, grief, and emotional stagnation. Her work focuses on bridging the mental health gap in underserved communities, with a special focus on gender equity and culturally sensitive care. She is also the co-founder of Sayfe Space, a mental health platform committed to making therapy and coaching accessible across South Asia and beyond. She has her private practice called ‘Safe Space with Cynia’ where she takes clients both virtually and in-person. She resides in Islamabad, Pakistan.
📸 Holding space for healing conversations in a culture that teaches silence. Every story matters.
References
- World Health Organization. Mental Health Atlas 2020 – Pakistan Country Profile. Published 2022.
- Savaira. org. Men and Mental Health: A Stigma. Accessed 2023.
- Qureshi, O. , et al. Implementation Challenges of Mental Health Services in Pakistan. International Journal of Mental Health Systems. Springer, 2024.
- Frontiers in Psychiatry. Mental Health Survey of Social Entrepreneurs During COVID-19.
- Dawn News. Entrepreneurs, Educators Share Stories of Resilience at IBA.
