Mothers are often seen as super humans who have it all together, while managing homes, birthing and raising children, keeping families together and often working full time as well. On Mother’s Day, they are showered with love, admired for their affection and devotion, but are never asked: “How do they really feel?” Because they are often seen only as strong caregivers and not the person they are. The living breathing person that could be sad, stressed or struggling with mental health.
In Pakistan, where an estimated 50 million people suffer from mental health issues, the burden is higher among women. Yet for many women, it’s overlooked, misunderstood, or dismissed. The consequences of this silence don’t just affect mothers, they deeply impact their children too.
According to a United Nations report, about 90% of women in Pakistan face mental and verbal abuse, and 50% face physical violence from their partners. Domestic violence is a major risk factor for depression and anxiety — especially during pregnancy. A study done in a rural area of Pakistan showed that over 26% of pregnant women were suffering from depression. In some areas, that number is even higher. In many cases, these women are struggling alone, without support from their families or husbands.
“Pregnancy is already a time of change emotionally, physically, hormonally. When women don’t receive support, that pressure multiplies,” said Dr Sadia Rehman, Clinical Psychologist and Psychotherapist. “A lot of women feel lost. They’re expected to be strong, but inside, they’re overwhelmed, and no one talks about it.”
She added that this emotional pressure builds up because women are often denied even the most basic emotional support. “Many new mothers don’t know what’s happening to them. They’re confused, anxious, and guilty. Some feel they’re not ‘good mothers,’ and that guilt eats away at them.”
But this is not just a mother’s issue. According to Dr Saad Malik, a practising psychiatrist who works closely with perinatal and postpartum cases, mental health issues in mothers have a direct impact on their babies. “There is now overwhelming evidence that maternal stress during pregnancy increases the baby’s risk for early developmental issues, including low birth weight and premature delivery. But what’s more alarming is the long-term emotional damage if the mother’s mental health remains untreated after birth.”
He explains that newborns are emotionally sensitive to the mother’s condition. “If a mother is depressed, disconnected, or anxious, the child doesn’t receive the warmth and responsiveness required for secure emotional bonding. That sets the tone for how the child learns to regulate emotions, how they build trust, and how they form relationships later in life.”
Dr Malik also explains that in clinical practice, he frequently encounters children with behavioural or emotional issues, and in many cases, their mother’s untreated mental health struggles were the root cause. “I see children with anxiety, anger issues, sleep problems — and when we trace it back, the emotional environment at home was often unstable during the child’s early years. Sometimes the mother had postpartum depression, sometimes she was emotionally neglected, and that emotional neglect silently transferred to the child.”
He emphasised that maternal mental health challenges are present in all income groups, but they present differently. “Women from lower-income families are physically and emotionally exhausted. They face unplanned pregnancies, poor nutrition, lack of education, and no access to mental health care. Their suffering is deep, and they’ve internalised that this is just part of life.”
Among upper-middle and affluent families, the suffering looks different but is equally damaging. “There’s a lot of performance pressure,” he explained. “These women are expected to be perfect mothers, look good, keep up with social appearances, and raise ‘achieving’ children. They suppress their emotions out of shame and try to act fine, which only worsens the internal disconnect.”
Dr Malik also brings attention to the emotional impact of gender preference. “It’s tragic but very common. If a woman already has two or three daughters, and she’s pregnant again, there’s immense pressure for her to have a son. If she’s having another girl, she’s made to feel like a failure. That baby is born into an emotional rejection. It affects how the mother feels about the child, even if she tries to hide it.”
According to him, these psychological wounds pass on quietly. “Children may not have the language to explain what they’re feeling, but they absorb the tension. Their bodies remember the stress. Their minds remember the emotional absence. That shows up later in the form of low self-esteem, dependency, or aggression.”
Dr Sadia Rehman highlighted that mothers with untreated postpartum depression often lose their sense of identity. “They stop seeing themselves as individuals. Everything becomes about survival. Feed the baby, bathe the baby, make food, clean the house. There is no pause to ask, ‘Am I okay?’ That emotional burnout becomes their new normal.”
She pointed out that many children raised in these environments show signs of emotional dysregulation, tantrums, delayed speech, and hyperactivity. “When we assess these children, the common factor is always the emotional climate of the home. And most of the time, the mother’s well-being was ignored.”
There is not much research available on mental health issues in Pakistan, one mostly has to rely on estimates or old data. In Pakistan, an estimated 80% of housewives who visit urban clinics are diagnosed with stress-related disorders, 65% of therapy-seeking individuals are women, mostly married, reporting high levels of family conflict.
And yet, the stigma remains. “There’s a lot of shame attached to mental health in our society,” says Dr Rehman. “A mother is expected to be selfless, strong, and giving. If she says she’s struggling, people think she’s ungrateful or weak.”
Dr Malik agreed by adding that even among educated families, there’s resistance. “Mental illness is still seen as a moral failure. A woman might be told to pray more, or to ‘snap out of it. No one tells her that postpartum depression is a medical condition. And no one tells her she deserves help.”
Both experts believe that the first step is conversation. “We need to normalise talking about these feelings,” said Dr Rehman. “Let mothers speak without judgment. Let them cry without being called dramatic.”
Dr Malik suggested including mental health screenings as part of regular prenatal and postnatal visits. “It should be standard. Just like we check blood pressure or haemoglobin, we should ask mothers how they’re feeling emotionally. And if there’s a red flag, follow up. Refer. Support.”
They also believe in the power of community and social media. “When mothers see other women sharing their stories online, they realise they’re not alone,” says Dr Rehman. “We need more digital platforms, safe spaces, and public health campaigns focused on maternal mental health.”
In the end, it’s about compassion. When we ask mothers, “How are you feeling?” And really listen, we begin to build a culture of care. Because a mother who is mentally well can raise a child who is emotionally strong. And that child becomes the future of our society.
As Dr Saad Malik 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’s a cost too high for any society to bear.”
