Increased prevalence of depression in Chitral

By Mir Hassamuddin Growing up in Chitral, while in middle and high school, I had never heard of the word depression nor knew of its deadly consequences. It is really heartbreaking to hear how often many people, especially youth, are suffering from various forms of depression and consequently committing suicide. The recent tragedy in Chitral where a former medical student killed himself and his counsellor is indeed shocking and alarming. I would like to extend my sincere condolences to the bereaved families and pray that Allah give them the courage and strength to cope with their loss and may the departed souls rest in eternal peace. Depression is a serious mental illness that intensely affects how we feel, think and eventually behave. In severe cases, depression can last for years and it robs lives or can cause permanent disability. It is deep, painful and a distressing disorder that is best managed with external support mechanisms. It is an illness that needs to be taken seriously and needs immediate intervention. Each individual manifests symptoms of depression in her/his own distinctive way and the causes and effects are also unique to each individual. There are so many symptoms associated with depression. Some of the common symptoms include change in appetite, decreased energy, sleep disturbances, feeling weakness, headaches, muscle aches and pains, having difficulty in remembering things, personal inadequacies, hallucination, and loss of interest, hopelessness and excessive guilt. As we all know, the topic of depression has become more publicly widespread and it is now well recognized across the continents. It affects both genders, male and female. Some of the research indicates that worldwide, depression affects 15% men and 25% women at some point in their lives which accounts for more than one hundred million individuals. Obviously, depression is not isolated to Chitral. While researching this topic, I was very shocked to find out that three million Canadians have serious depression and only one third seek help (Mood Disorder Society of Canada). The good news is that depression is a treatable disease if proper interventions are put into place in the early onset of the disease. The more prolonged one goes without treatment can adversely worsen the situation – results in further psychological damage which in some cases is harder to treat. Regrettably, there is no convenient tool such as ultrasound or X-ray machine to diagnose depression. It is only through a series of questions and behaviours examined by a psychiatrist that determines the severity of the illness. There is no proven evidence as to what exactly causes depression. However, there are a number of different theories referring to the varying factors that may cause depression such as chemical imbalances in the brain or family history. It also linked to stressful events such as death in the family, job loss, over use of medication, negative thinking, lack of will power, history of childhood physical and/or emotional abuse, medical illnesses, lack of social support networks, low income, unemployed and stigmas attached to unmarried individuals. In women particularly, factors that may possibly cause depression include oppression, childbirth and menopause. Regardless of what the causes are, it is important to know that depression can be successfully treated if the individual seeks help for this condition. As you can see from the above, contributing factors are influenced by social, biological, physical and/or psychological factors. At this point, it is difficult to determine the factors leading to an increase in depression rates in Chitral however further analysis is required. The healthcare institutions and the community at large should examine the increase to figure out what preventative measures can be put into place to control the onset of depression as well as, explore the many options available in treating people who currently have this condition. Immediate attention needs to be paid to this area as research in this particular field indicates that depression among youth also has adverse effects on their peers and families. Some of the treatment options involve medications, psychotherapy, cognitive therapy, interpersonal therapy, peer/social support, and in severe cases, hospitalization to ensure the safety of the individual themselves as well as the safety of others. Each of the treatment options have not been elaborated on in this article however if there is further need or interest, additional information on above treatment options can be provided. The key message is that depression is a treatable disease that can intermittently affect any of us throughout our lives as a result of external or internal factors. Knowing the symptoms and taking action, early on, to seek help will assist in controlling symptoms and in enabling one to live a productive and fulfilling life. Support from family/friends is another strong component in dealing with depression. I agree that the launch of a mental health program in Chitral specifically addressing gender and different age groups will be a big step towards successful rehabilitation of individuals. An extensive network of players within the healthcare system and from within the community in Chitral need to collaborate to support and advance this initiative.   The writer lives in Milton Ontario, Canada.]]>

5 Replies to “Increased prevalence of depression in Chitral”

  1. Thank you so much Najma for weighing in on the above subject matter. Your comments are encouraging and definitely credible.

  2. I would like to thank the writer for raising voice once again about this most vulnerable mental disease, which is increasing day by day in Chitral and other parts of the world, resulting suicide deaths and isolation. The recent incident of Sardar Ayub was a fresh example of severe depression which resulted into a homicide as well as suicide. May the departed souls rest in eternal peace and may Allah give courage to their families to bear the losses.
    On this occasion, it is obviously not important to do a critique on the contents of the topic rather focusing on the actual issue; so it is requested to be quiet if there isn’t something good to say.
    Depression has become one of the major challenges in Chitral region, especially in early ages, both in males and females. The most important thing on this point is to figure out the actual causes why these youngsters have become prone to this mental illness (depression). Another incident occurred today in Ovrik Garam Chashma where a young boy in early 20s shot himself dead for not having fulfilled his desire of love marriage. What is going on? Whose fault is this? Why is there a big distance between parents and their children? Why the children don’t feel easy sharing their problems and desires with their parents? Why are they this much helpless and hopeless and taking their lives? Why this issue is not being faced aggressively? Are we waiting for more more incidences? Why our sisters are jumping into rivers? Why our brothers shooting themselves so easily? Isn’t there any one to tell them the importance of human life? Is life so cheap for them or are they so desperate and dejected in our homes and society?
    Belonging to medical profession, I am very shocked and amazed to see the injustice for health seeking behavior between physical and mental health. We put all our wealth for physical health but never bother to seek attention for mental illnesses rather isolating the individual for social stigmas. Living in 21st century has not proven to create any positive transition in our thoughts for understanding these dilemmas. We still believe in local TAWEEZ and other PARI KHANS to treat serious mental cases like schizophrenia, mania, major depression and etc.
    It is my humble request to the NGOs and other health care sectors working in Chitral to do something aggressively to stop this epidemic before it takes many more innocent lives. These mental cases can easily be enlisted in the remote areas by means of research work. Moreover the DHG hospital must have a psychiatrist and other means of psychotherapies and cognitive behavioral therapies to deal with these cases seriously on regular basis.

  3. I would like to thank Ms Rehana for her comments regarding my article on depression. Whether depression is a medical condition or an emotional state of mind, as in your opinion, it is up for a debate. Some researchers do refer to it in a medical context due to possible neurological abnormalities or chemical imbalances while others have proven otherwise.
    Please refer to
    In my mind, however, you define it, is not significant and Canada is by no means immune to it. Here in Canada, there are also a greater number of incidences as well and by no means weather or social factors the only contributing factors. For further reading on this topic, please visit
    The most important point I wanted to raise through my article was that depression is treatable and does require individualized interventions based on symptoms presented.
    I really do appreciate your comments and welcome your support in providing additional information about this topic in the hopes of informing others on how to deal with this condition especially in vulnerable regions like Chitral.
    Mir Hassamuddin
    Milton Ontario Canada

  4. Depression is definitely a mental disease. You are talking about depression as a mood, Ms Rehana Webster, that people go through from time to time. The writer of the original post is talking about Major Depression, which is a mental disorder as stated in the Diagnostic and Statistical Manual of Mental Disorders (DSM). You are right that a lot of people suffer from SAD in Canada. I am from Canada too. But a large number of people also suffer from Major Depression, which our society, especially that of Pakistan’s is less accepting of. People don’t consider mental illnesses as an illness because you can’t see it as you would a physical illness. I think that the writer is trying to raise awareness, please don’t hush them up by saying that they’re wrong. If you are going to make a strong statement, maybe think about doing your research first. Here is a better explanation of depression straight out of the DSM: The DSM, by the way, is used by psychiatrists and psychologists world wide to help diagnose mental illnesses.

  5. Depression is not a mental disease, so please refrain from calling this emotional state of mind as a disease.
    You should know better, living in Canada as I have, that after the long winters and lack of sunshine, short daylight, a high percentage of Canadians suffer from S.A.D. or depression.
    Ever since Canada was colonized, people have struggled with winter blues. How about lack of Vitamin D? Yes especially in Chitral where people are covered up from head to toe and get no chance of utilizing the sun’s benefit of naturally making Vitamin D.
    Yes, there are issues like TV, media, cellphones and access to much information, for the youth to deal with. Many changes which the young people want and the culture cannot and is not ready to accept.
    So please do not label depression as a mental disease which it is not. Other mental diseases such as paranoia, catatonia etc., are certainly mental diseases but not depression.

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