Stress Awareness Day: Why Mental Illness is still a taboo in Pakistan? (Rava Special Report)


I am really stressed out!

All of us must have either used or heard someone say this in our lives. Yes, the word stress is used quite often in our lives. We hear about stress to young students, women and men of all ages …. Some time ago, stress was associated with senior executives with great responsibilities in companies; At present we can refer to any of us. There has been a rise in suicide rate in youngsters in Pakistan. n Pakistan one analysis of suicide reports, based over a period of two years, 2015 16- showed over 300 suicide deaths in Pakistan from 35 different cities. Out of 1,473 reported cases of suicide, 673 were reported in Sindh, 645 in Punjab. 121 in the KPK and 34 cases were reported in Balochistan. The problems stated for suicides, include unemployment, health, issues, poverty, homelessness, family disputes etc. People even forget that Islam does not allow this act in any circumstances.

In newspapers and magazines the subject also appears frequently, often associated with certain diseases. In fact, work-related stress is the second health problem in the European Union, and it is increasingly common for different specialists in medicine to consider it as an important risk factor.

It seems that stress affects us all, which is an epidemic.

For all this, we think it is interesting to continue disseminating information about what stress is, what effects it produces, what causes it, and. Of course. about what we can do to prevent it, control it or recover from its negative effects. So, with this, we started a series of entries on the subject.

Remember, what is stress:

The term stress is due to Dr. Hans Selye who, in the thirties, presented his research on what he called ”  General Adaptation Syndrome”

The stress response is, in reality, that: an adaptive resource. A resource that evolution has placed at our disposal to face threatening situations; Of course, this adaptation mechanism is not unique to our species.

This reaction, which affects the organism as a whole, since different biological systems are activated in an extraordinary way , makes available to the individual exceptional resources, which facilitate action and success in the face of the demand of the new situation.

Therefore, the activation or stress response is not a bad thing in itself, quite the contrary. Of course, it is a major wear and tear to the body. If this is episodic, and if there is sufficient recovery time, there will be no problem.

In fact, our biology has regulatory mechanisms that will try to return us to a state of homeostatic equilibrium But if the environmental conditions, for one reason or another, do not allow this return to balance or our own behavior makes it difficult, we can settle in a situation of permanent stress.

The importance of Relaxation and Stress Control

Take your mind where you want

Sometimes it’s hard to believe in relaxation, especially when stress is caused by an overload of work that you do not know how to get out of. The solutions, it is true, are not magical, but avoiding problems or seeing them as an impossible mountain to climb will not help us solve them.

The exercises that we propose today will not diminish your responsibilities, but they will ensure that you do not lose your temper at times when the tension increases . Will it work for something? Yes. Losing your nerves does not help, it only makes situations worse. Analyzing problems peacefully and finding solutions is a good start. The relaxation techniques we propose will help you manage stress and maintain psychological balance.

There are many techniques, but, in general, all seek to direct attention to what calms you and increase awareness about your body. Today we will tackle breathing, progressive relaxation and visualization techniques. No matter what technique you select, the important thing is to practice these exercises regularly. 

-We will start by breathing. By controlling the way we breathe, we will be able to cope with stress situations because we will get enough oxygen to reach our brain. The current rhythm makes it difficult to breathe completely and prevents our lungs from inspiring the maximum amount of air they are capable of. The goal of relaxation techniques through breathing is to automate this process and be able to apply it in situations of stress. Inhaling and exhaling through a deep breath and bringing attention to areas in which we feel body tension in order to try to relax them.

-Progressive muscle relaxation. It is about suppressing little by little all the muscular tensions in order to calm our mind. This method involves tensing slowly and then relaxing each muscle group. You have to tense the muscles for at least five seconds and relax them for 30 seconds and repeat the operation. In this way, a person can completely eliminate the muscle contractions and experience a feeling of deep relaxation. Progressive muscle relaxation reduces pulse rate and blood pressure. If done well, it can have the same effectiveness as a medication in reducing anxiety.

-Techniques of visualization.Through these exercises you can obtain a state of intense relaxation. It is about reproducing mental images to move your mind to another place or situation where you feel calm. During visualization, you have to use as many senses as possible. If we imagine, for example, that we are at sea, we have to think of the smell of salt water, the sound of the waves, the heat of the sun on our body. It may be easier to reproduce this feeling if we close our eyes in a quiet place and are comfortable.

Controlling relaxation techniques is a skill that is achieved with practice. You have to have patience to control them. Over time, you can recognize the muscular tension that stress situations produce in us and, when you start to feel it, fight it through relaxation techniques. And, above all, we should not be impatient. Try not to judge what happens around you during relaxation, just accept it. If one technique does not work, try another. Make practicing relaxation techniques a useful and beneficial tool.

Role of Family and Friends

Family members and friends of people suffering from anxiety problems are faced with a situation that, on many occasions, they do not know how to handle. This can lead them to feel confused and frustrated. It is important to know how to act in order to provide the adequate help and avoid attitudes or unsuccessful solutions that contribute to intensify and perpetuate the problem.

It is very common for the person suffering from an anxiety problem to show changes in their behavior. These changes can be a consequence of anxiety, or they can respond to the attempt to conceal or hide the problem (in case the person feels shame, fear of rejection, or do not want others to worry). Some examples of such behavioral changes may be: decreased interest in performing certain activities, excuses, irritability, changes in mood, withdrawal, avoidance of some situations, search for greater safety conditions, defensive attitudes ( vigilance, suspicion, susceptibility).

Here are some guidelines, sequenced, ranging from the most basic actions to those aimed at seeking professional resources external to the family environment, for the most serious cases.

We have grouped the steps to be followed in four major categories: Inquiry, contain, provide support, and encourage external assistance, if required.


In the first place, it is convenient to be interested and find out what is happening. Information gives meaning or meaning to things, increases our level of knowledge about them, and facilitates decision making. In this case, the first two sources of information could be:

  • The person who suffers the problem : listen actively to the person suffering from the anxiety problem and try to understand what is happening to them, without discrediting or distrusting them. If the affected person has already consulted with a professional, the attending physician for example, it is convenient to be interested in the assessment or considerations that he has made about the case.
  • Specialized documents of an informative nature : for a better understanding of the problem it may be useful to consult in depth specialized documents about what anxiety is, how it manifests itself, with what factors it is related, types, etc. This information can be obtained in technical books of an informative nature, or on accredited web pages of recognized institutions or professionals.


Containment goes one step beyond active listening, refers to the ability to become a depository of the problematic situation. It implies maintaining an empathic attitude, being able to put oneself in the frame of reference of the person who suffers, and showing willingness to help. Contain implies

  • An attitude of understanding, understanding, availability and assistance . Understanding and understanding does not mean talking too much, or continually, of the unpleasant feelings that anxiety produces, as this could contribute to maintaining them.
  • Become depositary, lend to share to download the other person . Sometimes, verbalizing fears and concerns makes us feel relieved. It is a temporary relief, given that by the simple fact of sharing them they will not disappear, but the truth is that they suppose a truce to the malaise.
  • Avoid trivialization and disqualifications . It is about trying to eliminate the fights, the reproaches, the ironic comments, the moral judgments. This type of behaviors will cause the person to feel prejudiced, ridiculed and rejected.
  • Avoid blame . To blame implies that all the responsibility of the problematic situation is attributed to the person who is suffering it. It may be that the alteration itself does not allow the person to take charge of the situation or apply solutions that in other circumstances seem easy. Blaming her can make her feel more distressed and helpless.
  • Do not dramatize or anguish as much or more than the patient . This way of proceeding would create even more alarm and would increase the inkblot effect of anxiety, which would tend to oversize.
  • Help to objectify situations . Anxiety implies a tendency to overestimate threats and underestimate resources. We can help analyze the situation in a more objective and realistic way to encourage the person to face it, instead of overprotecting it and corroborating their disproportionate fears.
  • Generate realistic expectations of solution . Interests that the person knows that despite having anxiety can get to have the necessary strategies so that it can be overcome: If at other times has been able to find answers to problems that seemed insoluble, can also be achieved this time.

Give support

The main effects of social support and instrumental support are the reduction of perceived stressors, the increase in the sense of satisfaction and the reduction of feelings of anxiety and depression. Support, in what way ?:

  • Encourage the patient to face progressively the fears and situations and / or circumstances that cause them: it is easy for him not to find the moment, fear does not make the situations that he takes over attractive. We will dedicate, regularly, a part of our time to support and encourage initiatives of that type: “we will try it on Wednesday afternoon”.
  • Be very attentive to the arguments that the person holds when he is reluctant to face the fears, since it is possible that fear is masked among very well elaborated excuses that may sound convincing.
  • Reinforce the progress that is being made (praise, praise, congratulations, celebrations …) and, above all, demonstrate satisfaction with the efforts made.
  • Offer help, without overprotecting , that will be withdrawn as the patient improves and to improve: it is understandable that when we see someone suffering or we care about us, we tend to try to alleviate that suffering in the short term in the quickest way we know . Overprotection is not a good strategy to help overcome the problem, it helps to keep the problem in the long term.
  • Prevent the problem from spreading : we can provide resources or conditions that limit the consequences of anxiety in areas that initially had not been interfered with by the problem, so that its harmful effects spread as little as possible.
  • Avoid sources of unnecessary stress : it is important to take into account that the person suffering from the anxiety problem is in a situation in which any small setback can act as trigger of their anxiety and maintain and intensify the problem.

Encourage external assistance, if required

If you detect that the anxiety worsens with the passage of time and check that the preventive measures are not working or are not enough, it may be useful to encourage the affected to consult your problem with specialists and provide information so you can access to an adequate treatment. Help generate realistic recovery expectations:

  • Looking for a text of self-help that fits the case: once we know what kind of anxiety problem the person presents, we can resort to specialized literature that provides suggestions or solutions.
  • Actively participating in the search for specialized help: The search for professional help can be a source of additional stress to the person suffering from the problem. Getting involved in this search is a form of emotional and instrumental support.
  • Collaborating with specialists in the application of any part of the therapeutic program, if necessary or advantageous: participation in the intervention process as a co-therapist or assistant, depending on the type of anxiety problem, is usually a fundamental part of the program of treatment. Your collaboration will be very well received and will be very helpful.


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Rava Desk

Rava is an online news portal providing recent news, editorials, opinions and advice on day to day happenings in Pakistan.


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