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Perspectives in Global Mental Health   |    
Depression in a Pakistani Woman
Anita Aijaz, F.C.P.S.(Psych.); Uzma Ambareen, M.D.
Am J Psychiatry 2014;171:729-731. doi:10.1176/appi.ajp.2013.13111548
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The authors report no financial relationships with commercial interests.

From the Department of Psychiatry, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan; and the Mental Health Clinic, Pakistan Association for Mental Health, Karachi.

Address correspondence to Dr. Aijaz (anita.aijaz@gmail.com).

Copyright © 2014 by the American Psychiatric Association

Received November 24, 2013; Accepted December 02, 2013.


“Ms. N,” a 27-year-old Muslim, Sindhi-speaking, married woman, born in a small village in Pakistan, the sixth of seven children, came to the city of Karachi after getting married 6 years ago. She is the second wife of a landlord and lives with him and their three children in a flat on the third floor of an old building. She arrived for her first appointment with a psychiatrist accompanied by her husband and their 3-year-old son. When the psychiatrist asked her the reason for her visit, she looked at her husband and said to him, in Sindhi, “You tell her.” The psychiatrist then addressed her in Sindhi (her own mother tongue), and the patient began to speak: “Doctor, I have become very sensitive. I start crying whenever I hear any bad news. I was not like this before.” She also complained of being unable to sleep, having no interest in anything, feeling as if there were no life in her body, and having difficulty in performing housework and looking after her children. She reported disturbing dreams in which she was surrounded by strange people and was anxiously searching for someone. She also complained of irritability, headaches, body aches, and feeling tired all the time. She had thought of seeing a spiritual healer (a murshid) in her village who had previously helped her, through prayers. During a previous episode of depression, she had been taken to see another spiritual healer (pir sahib), who told her that she was under the influence of the evil eye (nazar), and that her body needed to be purified. She had then gone to see him every Friday (the Islamic sabbath) with her family for various healing rituals, including recitation of Arabic verses from the Koran.

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