Mothers are often perceived as superhumans who effortlessly manage households, childbirth, child-rearing, family unity, and frequently full-time employment. On Mother’s Day, they are showered with affection and admiration for their devotion, yet rarely are they asked, “How do they really feel?” This is because they are often seen solely as strong caregivers, not as the individuals they are – living, breathing people who can experience sadness, stress, or mental health challenges.
In Pakistan, where an estimated 50 million individuals grapple with mental health issues, women bear a disproportionately higher burden. Despite this, for many women, these struggles are overlooked, misunderstood, or dismissed. The consequences of this silence extend beyond mothers, profoundly impacting their children as well.
According to a United Nations report, approximately 90% of women in Pakistan endure mental and verbal abuse, and 50% face physical violence from their partners. Domestic violence stands as a significant risk factor for depression and anxiety, particularly during pregnancy. A study conducted in a rural region of Pakistan revealed that over 26% of pregnant women suffered from depression, with even higher rates in some areas. Tragically, many of these women navigate these challenges in isolation, lacking support from their families or husbands.
“Pregnancy is inherently a period of emotional, physical, and hormonal shifts. When women lack support, this pressure intensifies,” explained Dr. Sadia Rehman, a Clinical Psychologist and Psychotherapist. “Many women feel adrift. They are expected to be strong, yet internally they are overwhelmed, and this reality is rarely acknowledged.”
She further noted that this emotional strain accumulates as women are often denied even the most fundamental emotional support. “Many new mothers are unaware of what they are experiencing. They feel confused, anxious, and guilty. Some internalize the feeling of not being ‘good mothers,’ and this guilt erodes their well-being.”
However, this is not solely a maternal issue. Dr. Saad Malik, a practicing psychiatrist specializing in perinatal and postpartum cases, emphasizes the direct impact of mothers’ mental health on their babies. “There is now compelling evidence indicating that maternal stress during pregnancy elevates the baby’s risk for early developmental issues, including low birth weight and premature delivery. More alarmingly, untreated maternal mental health issues after birth can lead to long-term emotional damage in the child.”
A representational image of hands showing the bond between mother and her daughters. — Canva
He elucidates that newborns are emotionally attuned to their mother’s condition. “If a mother is depressed, disconnected, or anxious, the child does not receive the necessary warmth and responsiveness for secure emotional bonding. This sets a precedent for the child’s emotional regulation, trust-building, and future relationship formation.”
Dr. Malik also points out that in clinical practice, he frequently encounters children with behavioral or emotional problems, and in many instances, the mother’s untreated mental health struggles were the underlying cause. “I see children with anxiety, anger issues, sleep disturbances – and upon investigation, the emotional environment at home during the child’s early years was often unstable. Sometimes the mother had postpartum depression; other times, she experienced emotional neglect, which was silently transferred to the child.”
He stressed that maternal mental health challenges transcend income groups but manifest differently. “Women from lower-income families face physical and emotional exhaustion, unplanned pregnancies, poor nutrition, lack of education, and no access to mental health care. Their suffering is profound, and they have internalized it as an inevitable part of life.”
Among upper-middle and affluent families, the suffering presents differently but is equally damaging. “There is immense performance pressure,” he explained. “These women are expected to be perfect mothers, maintain appearances, and raise ‘achieving’ children. They suppress their emotions due to shame and attempt to appear fine, which only exacerbates the internal disconnect.”
Dr. Malik also highlighted the emotional toll of gender preference. “It is a tragic yet common occurrence. If a woman already has two or three daughters and is pregnant again, there is immense pressure to bear a son. If she has another girl, she is made to feel like a failure. That baby is born into an environment of emotional rejection, affecting the mother’s feelings towards the child, even if she tries to conceal it.”
According to him, these psychological wounds are passed down silently. “Children may lack the verbal skills to articulate their feelings, but they absorb the tension. Their bodies remember the stress. Their minds remember the emotional absence. This later manifests as low self-esteem, dependency, or aggression.”
Dr. Sadia Rehman emphasized that mothers with untreated postpartum depression often experience a loss of identity. “They cease to see themselves as individuals. Everything revolves around survival: feeding the baby, bathing the baby, preparing food, cleaning the house. There is no moment to pause and ask, ‘Am I okay?’ This emotional burnout becomes their new normal.”
She noted that many children raised in these environments exhibit signs of emotional dysregulation, tantrums, delayed speech, and hyperactivity. “When we assess these children, the common denominator is invariably the emotional climate of the home. And most often, the mother’s well-being was disregarded.”
A representational image showing the silhouette of a mother and her child. — Canva
Research on mental health issues in Pakistan is limited, often relying on estimates or outdated data. In Pakistan, an estimated 80% of housewives visiting urban clinics are diagnosed with stress-related disorders, and 65% of individuals seeking therapy are women, predominantly married, reporting high levels of family conflict.
Yet, the stigma persists. “There is significant shame associated with mental health in our society,” says Dr. Rehman. “A mother is expected to be selfless, strong, and giving. If she expresses her struggles, she is often perceived as ungrateful or weak.”
Dr. Malik concurred, adding that even among educated families, there is resistance. “Mental illness is still viewed as a moral failing. A woman might be advised to pray more or to ‘snap out of it.’ No one informs her that postpartum depression is a medical condition, and no one tells her she deserves help.”
Both experts believe that the initial step is open conversation. “We need to normalize discussing these feelings,” said Dr. Rehman. “Let mothers speak without judgment. Let them cry without being labeled as dramatic.”
Dr. Malik suggested integrating mental health screenings into routine prenatal and postnatal check-ups. “It should be standard practice. Just as we monitor blood pressure or hemoglobin levels, we should inquire about mothers’ emotional well-being. And if there is a red flag, follow up with referrals and support.”
They also advocate for the power of community and social media. “When mothers see other women sharing their experiences online, they realize they are not alone,” says Dr. Rehman. “We need more digital platforms, safe spaces, and public health campaigns focused on maternal mental health.”
Ultimately, it comes down to compassion. When we ask mothers, “How are you feeling?” and genuinely listen, we begin to cultivate a culture of care. Because a mother who is mentally well is better equipped to raise a child who is emotionally strong, and that child shapes the future of our society.
As Dr. Saad Malik aptly put it, “When we ignore a mother’s mental health, we don’t just risk losing her – we risk the emotional future of her child. And that is a cost far too high for any society to bear.”
