The Growing Burden of Anxiety in Pakistan -

by Muhammad Mohsin Iqbal
A child enters the world without an understanding of fear, uncertainty or responsibility. His days are governed by immediate needs, and tomorrow holds no particular threat. But as childhood gives way to adolescence and adulthood, the mind gradually becomes occupied with questions about education, employment, financial security, family responsibilities and social standing. What begins as a natural concern for the future can eventually become a persistent psychological burden. In a society where economic insecurity and social pressures are widespread, the ability to preserve mental well-being is becoming an increasingly difficult undertaking.
At every stage of life, anxieties assume a different form. Students worry about examination results, admission to reputable institutions and the expectations of their parents. Those who struggle academically may become apprehensive about their prospects of finding employment and earning a respectable livelihood. For graduates, the transition from education to professional life often brings the frustration of unemployment and uncertain opportunities. Later, marriage, raising children, meeting household expenses and caring for ageing parents introduce further responsibilities. Even a medical emergency within a family can destabilise an otherwise settled household, particularly when treatment is beyond its financial means.
These concerns are not unusual in themselves; they are part of the human experience. The real danger emerges when pressures accumulate without adequate emotional, social or financial support. Persistent anxiety can develop into depression and other mental health conditions, impairing an individual’s ability to work, maintain relationships and participate constructively in society. Yet mental distress often remains invisible. Many people continue their daily routines while concealing their suffering, partly because society is more accustomed to judging emotional vulnerability than understanding it.
The figures presented before Pakistan’s National Assembly offer a disturbing indication of the scale of the problem. The number of people suffering from mental health conditions reportedly increased from 30 million in 2019 to 32.4 million in 2023. Against this growing burden, the country has only 1,050 registered psychiatrists. Of these, 406 serve in Punjab, 228 in Sindh, 122 in Khyber Pakhtunkhwa and just 44 in Balochistan. The disparity between the scale of need and the availability of professional assistance raises serious questions about the capacity of the public healthcare system to respond to this challenge.
The shortage is not merely a matter of numbers. Access to mental healthcare is further restricted by geographical inequalities, financial constraints, limited institutional facilities and the social stigma attached to psychological illness. In smaller towns and rural communities, specialist services are often difficult to obtain. Even in urban centres, treatment may remain unaffordable for families already struggling with basic necessities. Consequently, many people either postpone seeking assistance or suffer in silence until their condition becomes more difficult to manage.
Pakistan’s economic circumstances have added another dimension to this crisis. According to the World Bank figures cited for 2025, the national poverty rate reached 29 per cent, compared with 22 per cent in 2019. The report attributes the increase to inflation, rising prices of essential commodities, unequal distribution of resources and declining incomes among workers. It further estimates that 72.6 million people were living below the poverty line in 2024. Behind these figures are households making difficult choices between food, education, healthcare and other basic requirements.
Poverty is not simply an absence of money; it is also an enduring source of uncertainty. A father unable to meet his children’s educational expenses, a young graduate unable to secure employment despite years of study, or a daily-wage worker uncertain about tomorrow’s earnings may experience a level of stress that gradually affects the entire household. Financial insecurity can strain marriages, disturb family relationships and deprive children of the emotional stability essential for their development. When economic hardship becomes prolonged, hope itself can begin to diminish.
There is, therefore, a close relationship between economic well-being and mental health. An individual struggling with depression or persistent anxiety may find it difficult to perform professionally, make sound decisions or sustain productive relationships. At the same time, unemployment, poverty and financial uncertainty can intensify psychological distress. The two conditions can reinforce one another, creating a cycle that is difficult to break without institutional support and timely intervention.
Addressing this challenge requires more than advising people to remain patient or optimistic. Personal resilience matters, but it cannot compensate for the absence of employment opportunities, affordable healthcare and social protection. A comprehensive national response must recognise mental health as an essential component of public health rather than a secondary concern. Government hospitals need more psychiatrists, clinical psychologists and trained counsellors. Mental health services should be incorporated into primary healthcare, while educational institutions should provide appropriate counselling facilities to help students cope with academic pressure and emotional difficulties.
Public awareness is equally important. Psychological illness should not be treated as a source of embarrassment or a failure of personal character. Families must learn to recognise signs of emotional distress and respond with understanding rather than criticism. Employers and educational institutions should promote healthier environments in which individuals can discuss their difficulties without fear of discrimination. Early intervention, affordable treatment and community-based support can prevent many conditions from becoming severe.
Economic policy must also form part of the broader response. Controlling inflation, expanding employment opportunities, protecting workers’ purchasing power and ensuring a fairer distribution of resources are not merely economic objectives; they are also measures that can strengthen the psychological security of society. Development loses much of its meaning when ordinary citizens remain uncertain about their ability to afford food, education, housing and medical treatment.
Faith, family bonds, gratitude and a sense of purpose can provide individuals with valuable emotional strength. Physical activity, adequate sleep, meaningful social interaction and a balanced routine can also contribute to psychological well-being. Nevertheless, spiritual encouragement and personal discipline should complement professional care, not replace it when medical intervention is necessary.
The progress of a nation cannot be measured exclusively through economic growth, infrastructure or the strength of its institutions. It must also be judged by the security, dignity and peace of mind enjoyed by its citizens. Worries are an unavoidable part of life, but a society should not allow them to become an unbearable burden. Pakistan’s growing mental health challenge demands a response that combines economic reform, accessible healthcare, public awareness and compassion. The ultimate measure of development is not merely how much a nation produces or possesses, but how securely and peacefully its people are able to live.