THE WEIGHT WOMEN CARRY

mental health

For decades, the discourse surrounding mental healthcare in Pakistan has been confined to whispered conversations, closely guarded family secrets and the fear of “what will people say?” Seeking therapy has often meant admitting to a fundamental fracture in one’s character, while speaking about depression has frequently been dismissed as a spiritual deficit or a temporary phase of being “moody.” Enter Alizeh Valjee. Over the past decade, this dynamic practicing therapist, somatic dance facilitator and visionary entrepreneur has not merely entered the conversation; she has fundamentally rewritten its vocabulary. As the Co-founder and Chief Operating Officer (COO) of ‘Saaya Health’, an innovative, tech-enabled platform, Valjee has taken mental health counselling out of exclusive, stigmatised clinics and placed it directly within Pakistan’s corporate and community landscapes. With an academic foundation from Mount Holyoke College and an Advanced Diploma in Humanistic Integrative Counselling from CPPD, Valjee’s multifaceted approach seamlessly weaves corporate strategy with grassroots empathy.

“Mental health is not merely the absence of a psychological diagnosis,” Valjee asserts, defining the baseline parameters of her life’s work. “It largely consists of a person’s baseline mood - whether they are feeling low, upbeat or neutral - their capacity for emotion regulation and their core self-concept. It dictates how we see, understand and feel about ourselves.”

According to Valjee, psychological well-being is the primary engine behind human functioning and interpersonal harmony. When a woman’s mental state is compromised, the internal ripple effects are immediate. “Because our mental health shapes our thoughts and behaviours, it dictates how we show up in our daily lives. For example, a low mood can generate deeply self-limiting thoughts, while deep-seated fear can cause a person to perceive completely benign interactions as threatening. These self-limiting thoughts act as invisible barriers, preventing women from pursuing their life goals,” she elaborates.

“When our mental health is intact, we bring motivation and vitality to our occupations, whether that occupation is professional work or taking care of the home,” Valjee stresses. “If a woman has good mental health, she will be able to nurture her children, teach them about consequences in a healthy manner, set boundaries and be a positive role model.”

Valjee highlights that professional success and personal fulfillment do not exist separately. “Women are better able to show up at work when they are finding meaning outside of work as well. This applies universally, whether you are an early-career professional, a senior leader, an entrepreneur, a caregiver or a volunteer.”

When analysing the stark reality of gender-based mental health disparities, Valjee explains, “Unfortunately, in Pakistan, according to many research studies, being a woman puts you at a higher risk of developing depression and anxiety due to social and cultural factors, especially after marriage. Her new role comes with a lot of pressures - new relationships and new expectations. The relationship between husband and wife may not provide enough social support to buffer these new roles and expectations; rather, it may put a strain on the new marriage as well.”

For those who remain single, the ambient anxiety does not dissipate. For unmarried women, the pressure to get married can have a significant impact on mental health. Once married, reproductive expectations introduce an entirely new layer of potential trauma. “The pressure to have a child, the struggle to conceive and the burden of childbirth and miscarriage are other contributors to mental health issues,” Valjee notes. “Of course, raising children is its own stressor, especially when it’s being juggled with caring for in-laws, a husband, the home and in many cases, the woman’s career and her own parents,” she adds. “When women are placed under these pressures and not provided with adequate support, their mental health is inevitably impacted. This systemic neglect inevitably triggers a negative feedback loop, souring relationships with husbands, children and in-laws alike,” Valjee warns.

She also explains that biological events such as menstruation, pregnancy and menopause cause profound shifts in brain chemistry. Conditions such as Premenstrual Dysphoric Disorder (PMDD) can cause severe, debilitating emotional distress. “During pregnancy and the postpartum phase, the sudden drop in oestrogen and progesterone, combined with acute sleep deprivation, leaves women highly vulnerable to Postpartum Depression (PPD),” Valjee elucidates. In Pakistan, PPD is routinely misdiagnosed as simple physical exhaustion, further alienating mothers. Later in life, perimenopause and menopause bring significant hormonal transitions that can manifest as sudden anxiety, cognitive fog and depressive episodes. “Normalising these events as medical and psychological realities, rather than character flaws, is essential,” Valjee stresses.

When asked how women can actively push back against these pressures, Valjee advocates for professional guidance. “Therapy is a great tool for improving one’s mental health. It teaches emotion regulation skills and helps one identify and improve unhelpful thinking patterns that might be negatively affecting one’s self-concept and relationships.” Valjee argues that psychological care should be reframed as an absolute necessity. “To break the stigma around therapy, we must normalise mental healthcare as regular healthcare. We need visible, transparent storytelling. When influential women, corporate leaders or family elders openly share their experiences with therapy, it strips away the associated shame,” she states.

To bridge the gap between individual therapeutic needs and systemic access, Valjee co-founded Saaya Health, an enterprise that experienced exponential growth amid the collective trauma of the COVID-19 pandemic. “When the pandemic struck, isolation and the blurring of boundaries between work and home life brought mental health to the forefront of global priorities,” she reflects. Recognising that mental healthcare must be integrated into the places where adults spend the majority of their time, Saaya Health pioneered comprehensive Employee Assistance Programmes (EAPs) across the region.

Today, major corporate entities such as UBL, P&G and Daraz utilise their platforms to provide confidential counselling, 24/7 crisis hotlines and preventative workshops. Saaya has also scaled across borders, implementing well-being programmes for over 280,000 migrant workers in the Middle Eastern oil and gas sector.

“Workplaces can play a pivotal role in supporting women’s wellbeing by creating structures that recognise their needs. Sensitising teams, especially managers, about the transition women experience during maternity leave and upon returning to work can foster empathy and reduce stigma,” Valjee suggests. “Practical support is equally important. Flexible or customised roles can ease the transition back to work, while on-site daycare, which is still rare in Pakistan, can significantly reduce the burden on working mothers,” Valjee adds.

She advocates for the widespread implementation of EAPs, which provide counselling and anonymised organisational insights that help employers improve workplace culture. Ultimately, she insists that true equity can only be achieved when policies addressing women’s health, safety and sociocultural realities are shaped with women meaningfully represented at decision-making levels.

To build a more resilient future generation, Valjee focuses heavily on the classroom. “Education lays the groundwork for building emotional awareness and resilience. When children are taught to communicate more effectively and develop resilience and internal capacity in healthier ways, they can have better outcomes later in life.” Rather than leaving emotional growth to chance, Valjee argues for structural curriculum design. “I believe that social and emotional skills should be taught in schools. This will equip people with the skills they need to cope with personal challenges in a healthy manner.”

To address this issue, Saaya Health partnered with child psychologist Areej Jaffrani to publish a bilingual journal tailored for children aged 7 to 12, titled ‘My Marvelous Mind: A Journal for Big Little Emotions’. The book teaches children about their emotions, thoughts and self-esteem. It is available in both English and Urdu.

Valjee calls for a comprehensive, multi-tiered overhaul of how Pakistani society treats women, beginning within the household. “Firstly, it is important not to place unrealistic expectations and unnecessary pressures on women. Families should ensure that women are satisfied with their occupations - both domestic and professional - and that they have the adequate support they need to sustain them and succeed in them.” For those facing clinical challenges, her directive is clear, “Women with mental health struggles should be supported in accessing and sustaining the treatment they require, be it therapy, medication or alternative therapies.”

Ultimately, Valjee views mental health as an ecological ecosystem dependent on lifestyle and public infrastructure. “Having a healthy lifestyle - good nutrition, a healthy sleep routine, exercise, access to sunlight and greenery and time for hobbies - is essential for everyone, but even more important for those with mental health struggles,” she stresses.

“The government and community should work towards making all spaces safe and comfortable for women so that they can experience less anxiety as they go about their day-to-day lives,” Valjee concludes.

Sumeha Khalid is a seasoned journalist and former editor of Mag The Weekly. She can be reached at [email protected]