Many students in Pakistan continue to hide behind their mental health labels – it is time to destigmatize them

I sat by the window in an empty classroom on a cold winter morning. Outside, children arranged in lines for the morning assembly. I didn’t want to be a part of the crowd, so I stayed back. As students shuffled back into their classrooms, the empty corridors thronged with life.

I felt anxiety pricking at my nerves as the sounds grew louder and one of my classmates walked up to me. She yanked at my arm and asked me if something was wrong. I stayed silent. She asked me again. The second time, I felt tears stinging at the back of my eyes.

I was in tenth grade when I first experienced depression. Back then, I only had a distant idea of what depression meant. I thought it only affected adults, or those who had lost their loved ones. Over time, I learned that depression had no preplanned targets. It could settle around anyone, and at any time.

Depression, for me, was the loss of ability to feel. It was a sense of hollowness within. I lost touch with all that I loved. I stopped painting, I stopped writing, and I stopped meeting friends. Small tasks suddenly felt large. My academic performance declined to the extent that I started failing exams and missing school. Towards the end of the academic year, my teacher pointed out that my attendance had fallen too low and that I may not be allowed to sit my final exams. I told her I was missing school because there were problems at home.

Because of inadequate counselling facilities and oversight, educational institutions have no safe spaces for students to shed their anxieties, which ensure privacy of students and confidentiality of conversations. So, when my teacher insisted on knowing the details of what the problems were, I told her, ever so reluctantly, as I thought I could confide in her.

A few days slipped by in silence, and then my teachers had a meeting with my parents. They divulged the details of the conversations I had had with them. It was then that I realized I had made a mistake by trusting them. I felt guilt in the pit of my stomach as my parents confronted me, with a dark furrow of frustration on their faces. No one outside our immediate family was supposed to know about our struggles. I had betrayed them, they said.

Pakistan’s education system is flawed on multiple levels, but the scope of conversations pertaining to these flaws are often limited to the financial, physical and faculty-based infrastructures of educational institutions.  Mental health issues—which are unsurprisingly commonplace among students—hardly ever make it to these discussions. The irony is that the same institutions which create stress-inducing, high-pressure environments, are the ones which provide little to no coping mechanisms and services. Further, the burden to conform to societal pressures falls heavily on victims of mental illnesses. The “log kya kahainge” (what will people say) narrative especially dissuades young people from seeking help in Pakistan. They are commonly told that depression at their age is not, and cannot possibly be real.

Instead, in order to exist outside of the labels forced upon them, they suffer in silence. Many start believing that their feelings, struggles and experiences are invalid.

Increasingly competitive environments at schools and universities can also lead to students resorting to self-harm. High pressure combined with poor results and untenable expectations from peers, parents and relatives often leads to students losing their self-worth.

“I wish I could tell somebody what I was going through,” says Aisha*, currently a third-year student at university. “But I didn’t, because I felt nobody wanted to know.”

Aisha was expelled from university at the end of the first academic year due to low grades. She didn’t tell her parents for months, simply because she was afraid of their reaction. Aisha wrote several emails to the university administration, but she didn’t hear back from them for many months. When she eventually did, she was told that she was a weak student and should transfer to another university.

“When I told my mother about my university’s decision to expel me, she flew into a rage. She slapped me, tugged at my hair, said vile things. I told my mom this wasn’t my fault—sometimes furiously, sometimes through tears. She didn’t believe me. And maybe, I didn’t either,” she said.

That was the beginning of Aisha’s struggle. Each day, she fell deeper into depression, and had no one to help her out of it.

“I was always a good student. I didn’t know this could happen. But this one decision by the university changed everything. I felt as if someone had lifted my world and turned it sideward. Everything suddenly felt different.”

When she saw no way out, she was overcome with an urge to hurt herself, to punish herself. She thought she was responsible for putting her family through this difficult time. When her mother said that she couldn’t face others because of what she had done, she resorted to self-harm.

“I remember digging my nails into my cheeks. My face was smeared in small, dark lines in places where my cheeks bled,” Aisha said.

In Pakistan, an important reason why most students suffer is the pressure to meet society’s expectations. Mostly, students are expected to tread on two career paths—medicine or engineering. Although the narrative is gradually changing, social sciences, art, teaching and similar fields are still not recognized as “respectable” or “profitable” careers. As a result, many students find themselves sinking under the pressure of pursuing careers that are considered satisfactory to the society at large.

The traditional Pakistani family obligation is for the children to follow the expectations of their parents – a norm that when challenged, is tantamount to launching yourself into an impossible battle with decades of ingrained, intrinsic culture. Arya* grew up in a society that told her she would only be successful if she pursued a career in medicine. She grew up around people who echoed that her family and societal expectations were more important than her personal goals or ambitions. She studied pure sciences in high school. She thought her dreams lay in her parents’ expectations, and accordingly envisaged becoming a doctor one day.

But it wasn’t meant to be. Unfortunately, her academic results were below par, and she took a year off before attending university. This gap year for her meant fighting an uphill battle against depression.

“I wanted to go someplace far, away from all prying eyes. I just couldn’t face the world. I didn’t eat for days. I cried myself to sleep each night. I turned inwards. I didn’t talk to anyone for days on end. I avoided my family. I ghosted my friends. Everything changed in the blink of an eye.”

When Arya’s result came out, her parents told her that she never had it in her to become a doctor. They asked her to pursue a degree in Economics instead because it would be easier for her.

“I was embarrassed because I couldn’t make it to a reputable university. My dream of becoming a doctor was crushed. I fell short of my parents’ expectations. I thought I’d never be successful now.”

As students, the burden of societal expectations rests solely on our shoulders. We are expected to follow that which has been determined for us because “adults know best”. And while we’re on this journey, we’re met with intense levels of academic pressure, we’re expected to thrive in exceedingly competitive environments.

Our parents don’t believe us, and our teachers don’t believe in us.

Mental health problems are a reality for most students surviving in academic environments. But mostly, our struggles fall through the cracks. There’s no help available to us. Depression isn’t simply being upset over grades or being told off by a teacher. It’s something deeper, lasting, more damaging. Sometimes, you can’t fight this battle alone.

Sometimes, it can mean crying sitting at the end of a classroom. And sometimes, simply looking out of the window, gazing at the empty sky.

*Names have been changed to protect anonymity.

Izza is a university student in Lahore, Pakistan, where she’s focusing on Economics and Politics. She’s a budding human rights activist, and runs a blog called Escaping Space which documents the lives of underprivileged Pakistanis.

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