Life is hard. In the pressure cooker created by the stresses of modern life, more and more people are succumbing to unseen ailments like depression, anxiety and their dreadful older sibling: Post Traumatic Stress Disorder (PTSD). Although invisible, these ailments are very real to the people suffering silently. And there are plenty of them across the globe. An estimated 300 million people are suffering from depression worldwide (WHO, 2017).
Pakistan (never to be left behind on dismal statistics) displays a population where 34% of us are suffering from depression, according to the Pakistan Medical Association (PMA). Similar numbers for anxiety and PTSD are not readily available, displaying an alarming apathy for these very real and widespread disorders. Over all, as noted by senior psychiatrists at a press conference in 2011, there had been a “100 % rise in the incidence of mental disorders, particularly stress and depression, in the country over the past 10 years”.
The reasons for more and more people succumbing to all of the above exist within a large spectrum of problems faced by Pakistanis every day. As the journalist Rahat Kamal entertainingly pointed out they can “range from deranged mothers-in-law to drive-by shootings”.
Adequate access and support for this growing number of individuals is extremely hard to find. There were 3,729 outpatient mental health facilities and five mental hospitals in the country according to a WHO-AIMs report from 2009. The report also states that there are only 342 licensed psychiatrists. By 2015 this had increased to 380 trained psychiatrists as found by a survey conducted by the Pakistan Association for Mental Health (PAMH) in collaboration with the Human Rights Commission of Pakistan (HRCP) and Mental Health Forum. There were 478 psychologists, 3145 social workers and 22 occupational therapists for the entire country. Children and adolescents have even less support with the report stating that out of all the outpatient mental health facilities only 1% are specifically catering to the demographic. This is not surprising as only 0.42% of the budget was allocated to mental health according to the Pakistan Economic Survey for 2016-17.
The lack of support is leading to people looking for solutions in the wrong places. Reports claim 476 million anti-anxiety tablets were sold in 2012 and the Network for Consumer Protection found that the sales of antidepressants, tranquillisers and hypnotics, and antipsychotics were PKR 821.17 million, 1.36 billion and 377.02 million respectively in 2006 (latest figure available). Most people just tell their loved ones who suffer from any of these disorders to relax and be happy.
Never in the history of mankind has someone told that been able to just flick a switch and immediately start dancing to the beautiful beat of life. It is a process which needs proper frameworks and tools to be accomplished.
An alternate solution
One alternate solution could be the proper practice of Yoga, a discipline encompassing spiritual, mental and physical wellbeing, which gained the status of a UNESCO “Intangible cultural heritage” in 2016. However, it dates back to pre-Vedic times when philosophies were passed down orally from sage to student and therefore mostly lost – until a scholar Rishi Patanjali (thought by some to be the father of Yoga) wrote down these philosophies from Vedic and Tantric traditions sometime around 600 BC in the form of Sutras (like poems in the ancient language of Sanskrit). Since that time very little had changed until the last century, with wise women and men bringing the practice into the ‘New World’, during the 19th century. Now, a largely commercialised version has swept across the West. At times merely reduced to another form of exercise, it became a commodity with brands like “Bikram Yoga” opening studios on every corner.
Urban Pakistan has been experiencing a similar yoga revolution of late. An abundance of yoga studios have popped up and more and more gyms are offering yoga classes. While this sounds great on a basic level, it is also a real shame to see the essence of this beautiful philosophy and way of life being lost to the lowest common denominator – weight loss. Most of the classes I have been to do not even begin to scratch the surface of this multi-layered concept, opting instead to put students through grueling Asanas (or postures) for an hour with no hint as to the wealth of knowledge available for personal – and not just physical – transformation. There is also no chance to get children involved as they need more imaginative and less demanding practice than what is currently available.
Students practice breathing at the Nepal Yoga Academy
Accordingly, as stated by the Nepal Yoga Academy in their teacher training manual, two questions need particular consideration: “Is Yoga being taught the way it should be?” and “Is Yoga becoming too commercial and diverging from its authentic track?”
Before proceeding, one issue that needs to be laid to rest is that classical Yoga (not its commercial ‘Bikram’, ‘Power’ or ‘Core’ forms) is not Hinduism – which many people in Pakistan and around the world seem to believe. In fact, according to the Yoga Journal “the origins of Hinduism, Buddhism, and yoga are Vedic, which predates the kind of formulation of what we call modern Hinduism.” Consequently, it can be seen as a stand-alone philosophy which can run in parallel to individual religious affiliations.
One way of looking at yoga holistically
According to Patanjali there are eight limbs of Yoga. These include external practices of Yamas (social codes), Niyama (personal code), Asana (postures), Pranayama (control of breath) and Pratyahra (withdrawal of senses) as well as the internal practices of Dharana (concentration), Dhayana (mediation) and Samadhi (deep meditation). As can be seen in most cases, classes in Pakistan are only concentrating on external practice, in particular the third limb of postures with a select few putting in a cursory practice of the forth limb or breathing exercises. Most lead the class in such a fast flow of postures in a single-minded attempt at weight loss that students sometimes do not even have time to concentrate and enjoy the sensations that they might feel from them. This fact is sadly obvious in the numerous ‘before and after’ pictures and testimonials that most studios use as advertisements on social media – quantifying the benefits of this wonderful philosophy in mere kilograms.
So the argument is not “Yoga verses Pilates or the gym” as some people like to weigh in. As put by Warren Buttery (Australian Army Retired), Yoga Teacher at the Nepal Yoga Academy (when asked what the practice means to him), “Yoga is a great philosophy for life.” While staying at the academy this month I was personally introduced to the wealth of benefits of yoga when taught holistically and mindfully. I came into the course stressed and under pressure. Two weeks later I left a new person with some of the tools to cope with traumatic events which can be applied daily and carried anywhere.
It is a real shame to see the essence of this beautiful philosophy and way of life being lost to the lowest common denominator - weight loss
However, only the more affluent classes in Pakistan can go to Nepal, Thailand or even India (in some cases) to discover the tools to be able to cope with the outer world while getting in better touch with their inner world. Local understanding now needs to be deepened in order for more seekers of peace to be able to find it. It can’t just remain a refuge for adults in the wealthy urban classes. Children need to be brought closer to mindful philosophies like this to better prepare them for adulthood in this violent society. Similarly, the rural population has minimal traditional or alternative support. A large proportion of residents from the tribal regions and north-western Pakistan are suffering from PTSD after years of conflict, natural disaster and political upheaval with limited access to treatment or mental health facilities. In 2013 the New York Times reported that “sales of sleeping tablets, antidepressants and medicine to treat anxiety have soared” in these regions as a consequence.
Practices like Yoga, being better understood and made more widely available, may be able to bridge the access gap to support those suffering from depression and anxiety disorders across the country.
