The name change was published in The Lancet medical journal and announced at the European Congress of Endocrinology in Prague on Tuesday. It came after 14 years of collaboration between international societies and patient groups.

According to the medical journal, PCOS has primarily been perceived as a gynaecological or ovarian disorder, however, research has shown that it is underpinned by endocrine disturbances in insulin, androgens, and neuroendocrine and ovarian hormones.

“The broad clinical features of the condition are not captured in its current name, as although arrested follicular development is common, pathological ovarian cysts are not increased. These factors delay diagnosis — with up to 70pc of affected individuals remaining undiagnosed — and also contribute to widespread knowledge gaps and patient dissatisfaction.”

The Guardian reported that the renaming was spearheaded by endocrinologist Prof Helena Teede, director of Melbourne’s Monash Centre for Health Research and Implementation. Experts, including Teede, have said the misleading nature of the term “polycystic” in PCOS contributed to delayed diagnosis and inadequate medical care.

Announcing the new name at the European Congress of Endocrinology, Teede said the term PCOS didn’t capture the “multi-system burden that people with this condition have suffered”, and instead “directs attention to only one organ”.

It is hoped that the new term — PMOS — will better reflect the condition’s complex nature, as it affects not only the reproductive system but also the metabolism and the risk of diabetes and cardiovascular disease.

During such difficult times, we wanted to give our readers a guide on how to get through the city’s summer and the many challenges it brings with it.

1. Hydrate well and often

Conventional wisdom says you should aim to drink around eight glasses of water a day, but desperate times call for desperate measures.

In this blistering heat, we’d recommend drinking two to three litres of water a day, ideally with some salt or lemon juice added to boost the body’s electrolyte count.

We also suggest keeping a couple of packets of Oral Rehydration Salts (ORS) handy in case you or someone around you is feeling the effects of dehydration.

2. Stay indoors

Avoid going outside as much as you can and avoid standing in the sun, even if you have to be outdoors. Try to find some shade — a shed, a tree or the shadow of a building.

If you’re facing a power outage at home, try hanging wet sheets of cloth on your windows, this will cool the usually hot wind blowing in and make it a little more bearable — it’s what people used to do in the days before air-conditioning.

Use curtains, blinds — and wet sheets — to block out the sun during the day and open them at night to help the day’s accumulated heat escape.

3. Dress to survive

In this weather, fashion takes a backseat and the priority should be to wear loose-fitting, light and breezy clothes that let your body breathe. Go for cottons and linens, avoid heavier fabric and dark colours that might soak up the sun’s light.

Hats haven’t really been ‘in’ for some time now, but they can save your life in this weather. Wear wide-brimmed ones; the wider, the better, straw, boonie and bucket hats are best suited for this.

Umbrellas, also out of non-monsoon fashion for as long as anyone can remember, are also a good way to shield yourself from the unforgiving sun.

4. Be mindful of those around you

You’re not facing the elements alone, so try to carry some extra bottles of water for anyone who may need them, especially people working in the sun like construction workers, hawkers, traffic police officers and delivery riders.

You should also know how to recognise if a person is suffering from heatstroke and how to render necessary first-aid. According the Mayo Clinic, symptoms include dizziness, nausea, rapid pulse and breathing, headaches, fever and either excessive sweating or no perspiration at all.

You should call emergency services immediately if someone is experiencing heatstroke and try to cool the person down. Bring them into a cool, shaded environment and wet their body, especially around the neck and armpits.

If the person is conscious, offer them chilled water and some of that ORS we said you should carry. If they are unconscious and you can’t feel their pulse, begin CPR immediately.

5. Animals need your love too

While we can do so many things to escape the heat, stray cats, dogs and birds don’t get as many choices in the matter, so be kind to them please.

Open your porches, terraces and any covered spaces outside your house to animals and leave out some food and a dish of water for them to drink.

When taking out your cars, check to see if any animals are sheltering under them to escape the sun, give them a little nudge before your fire up your engine.

As long-term solutions to Karachi’s heat crisis involving large-scale tree plantation and pedestrian-centric urban design seem distant, people will have to personally adapt to rising temperatures in the short-term.

These precautions and practices will help you live better and safer in the coming days.

The Seoul Metropolitan Government staged its third annual spring event, dubbed a power nap contest, from 3pm, under a refreshed set of admission requirements for would-be participants: wear outfits befitting either a sleeping beauty ​or prince, come tired, with a full belly.

For a metropolis that famously runs on ​24-hour shopping malls, competitive hustle and iced Americanos, the underlying exhaustion on the ⁠lawn was palpable.

“Between exam prep and part-time jobs, I survive on three or four ​hours of sleep a night, patching it up with desk naps during the day,” said Park ​Jun-seok, who showed up draped in the silken, crimson robes of a Joseon Dynasty monarch.

“I’m here to show off my napping skills, and to demonstrate exactly how a king sleeps,” said Park, a 20-year-old university student.

Nearby, Yoo ​Mi-yeon, 24, an English teacher from Ilsan north of Seoul, stood out in a plush, oversized ​koala-themed onesie. “I’ve always suffered from insomnia, I struggle to fall asleep, and wake up easily,” she said. “Koalas are ‌famous ⁠for their deep slumber. I came dressed as one hoping to borrow a little of their magic.”

Now in its third consecutive year, the sleep competition underscores a chronic issue for South Koreans. Data show South Korea is one of the most overworked and sleep-deprived nations among Organisation for Economic ​Co-operation and Development members, ​and, as a consequence, ⁠people have some of the fewest sleep hours.

As the clock struck three and eye masks descended across the park, officials went around to ​measure participants’ heart rate to make sure they had a stable reading - ​an indicator ⁠of deep, peaceful sleep.

The winner of the contest was a man in his 80s.

Hwang Du-seong, a 37-year-old office worker, was a runner-up. “I was completely drained, having done night shifts often on top of ⁠going ​to work everyday plus I also drive a lot ​for work. So when I saw the contest I was determined to sleep to fully recharge amid river breeze, and ​I’m very happy to be placed second place, luckily.”

We have been taught to consume such stories as masala — something to cry over and then forget once the next episode airs. But what if I told you that millions of viewers are not just watching the protagonists Jami (Emmad Irfani) and Zeba (Sanam Saeed)? They are watching their own fathers, their own mothers and echoes of their childhood selves. Kafeel is not a drama; it is a mirror of the dysfunctional family system hiding in plain sight across our homes.

At its core lies one narcissistic, self-absorbed, and irresponsible father — Jami. His emotional unavailability isn’t passive; it’s destructive. He doesn’t just make mistakes, he weaponises irresponsibility. His wife Zeba, a victimised mother trapped in learned helplessness, becomes the silent enabler. Together, they create a pressure cooker that warps each of their four children in profoundly different ways. From parentification to phobias, from internalised guilt to behavioural mimicry — let’s take a mental health deep dive into Kafeel.

The father – Jami (The malignant source)

Jami is the epicentre of the family’s pathology. He perfectly fits the archetype of the “covert narcissist” — lazy, entitled, deeply insecure, yet charming in public. His gaslighting is textbook: he blames Zeba for his own failures and makes her feel responsible for his inability to work and provide for his family. He doesn’t need to be physically violent; his emotional and financial abuse is enough to trap and damage the entire family.

But here is the nuance Kafeel bravely offers: Jami himself did not emerge from a vacuum. His own patterns are the result of a dysfunctional family setup that he was born into. His siblings used him as a caretaker for their ageing parents, while they provided financial support from abroad. He was never pushed to complete his education or pursue a career and this turned him into an entitled, stunted adult. This does not excuse his behaviour — but it explains it, which is the first step away from blind hatred and towards breaking cycles.

The mother – Zeba (the victim and the enabler)

Sanam Saeed’s portrayal of Zeba is heartbreaking because she plays her character not as weak, but as exhausted. Zeba was conditioned to be ‘sweet, obedient and naïve’ and her silence is not passive — it’s a trauma response called learned helplessness. After years of being oppressed, she has given up fighting back. Her decision to stay with Jami “for the children” is the very thing that damages them the most.

Yet Kafeel offers a quiet, powerful arc: her midlife enlightenment. This makes sense, as midlife is often when early-life trauma knocks again, begging to be resolved. Zeba’s slow awakening is a gift to every woman watching Kafeel who still believes it is too late for her.

The four wounded children – A psychological breakdown

Each child is a unique case study of how a child adapts to survive a narcissistic, abusive parent. It’s a masterclass in the ripple effects of a dysfunctional family system.

The eldest son – Subuk (Aashir Wajahat): the parentified child

Subuk was forced to grow up overnight and become the emotional and financial support his mother needed and the father figure his sisters lacked. His low self-esteem doesn’t come from failure but from the immense pressure of holding a broken family together. This is called role reversal trauma — and it often follows children into adulthood in the form of chronic anxiety, an inability to relax and a compulsive need to fix everyone around them. No one in the drama ever tells him that he is just a child or that he shouldn’t have to carry such a burden.

The eldest daughter – Javeria (Nooray Zeeshan): the blame sponge

Javeria has learned that the only way to feel safe is to over-control herself and take responsibility for everything. She blames herself for the family’s fights, financial problems and even her father’s moods. This is a classic survival mechanism: if she can fix what’s ‘wrong’, maybe the chaos will stop. She becomes a people-pleaser with zero self-worth — hallmark signs of growing up with a volatile, unpredictable parent. In therapy, we see Javerias everywhere: brilliant, kind women who apologise for existing and believe that love is something they must earn through suffering.

The middle sister – Zoya (Haya Khan): confident but phobic

Zoya shows us how trauma can become somatised — locked into the body’s nervous system. Her fear of sharp objects (aichmophobia) is not irrational; it is a conditioned response to her father, who threatens the family with a knife frequently. Her confidence is a mask. Underneath, her body remembers the terror. This is one of Kafeel’s most brilliant threads: trauma does not always look like sadness. Sometimes it looks like a strong, sharp, seemingly put-together daughter who cannot hold a kitchen knife without her pulse skyrocketing.

The youngest daughter – Tania (Hania Ahmed) — the mimic

The youngest child is the most chilling example of how abuse normalises pathology. Tania has learned that, in this family, there are no real consequences for bad behaviour, because her father models it daily. By using “my father does it too” as an excuse, she is not being inherently manipulative; she is mirroring the survival tactic she has observed. If the most powerful person in the house can get away with anything, why can’t she? This behaviour is a learned adaptation to a dysfunctional environment, and it highlights the danger of normalising toxic traits. Without intervention, Tania is at the highest risk of becoming like Jami in her future relationships — not because she is evil, but because she associates power with this way of being.

Intergenerational trauma

One of the most upsetting moments in the series is when we see Subuk begin to mimic his father’s aggressive behaviour. In that moment, we see the future. The abused becomes the abuser. The drama masterfully shows that, without intervention, children will carry their parents’ patterns into their own relationships, perpetuating the cycle for another generation.

This is why Kafeel is so important. It is not just a story; it is a warning. It is a call for self-awareness, for breaking the cycle and for prioritising mental health over societal pressure. We cannot heal what we refuse to name.

But here is the truth that Kafeel doesn’t show — or hasn’t yet — because dramas rarely do: the cycle can be broken. A narcissistic father does not have to define your future. A victimised mother does not have to be your blueprint. Parentification, guilt, phobias and mimicry are adaptations, not life sentences. With the right support — therapy, self-awareness and healthy boundaries — each of these wounded children can reclaim their mental health.

Intergenerational trauma is powerful, but not necessarily a destiny. Healing begins by naming the wound and choosing to stop passing it down. Kafeel warns us, but your life can prove that your story ends differently.

Why Kafeel is essential viewing

Kafeel is not a drama; it’s a psychological case study disguised as entertainment. It shows that abuse is rarely just a slap. It is the slow, silent erosion of a person’s will, and the insidious poisoning of the next generation.

This drama is a mirror for every household where one broken parent created four differently broken children. Kafeel exposes the mental health legacy of a toxic father. It forces us to ask a difficult question: how many of our “family dramas” are actually multi-generational trauma centres?

None of this analysis would be possible without the bravery of writer Umera Ahmed, the brilliance of director Meesam Naqvi, and the courage of ARY Digital for airing this raw and uncomfortable story. Mainstream Pakistani dramas often romanticise toxic relationships or resolve complex trauma with a single emotional scene. Kafeel refuses to take that shortcut. It trusts its audience to sit with the messiness, to recognise the subtle signs of narcissistic abuse and to understand that healing doesn’t happen in one episode.

This is not just good television. This is responsible storytelling. And it deserves recognition.

Originally published in Dawn, ICON, April 26th, 2026

The star posted a video on Instagram from the gym on Wednesday with a caption asking viewers whether they would choose “familiarity or evolution”.

In the clip, Abbas talked about her own mental health struggles, saying, “For the longest time, I didn’t know how to validate my feelings.” She said therapy works when it comes to that, but there was more that kept her going.

“I was working out at the gym and I realised, what is this thing that makes me feel happy, and that makes me feel validated,” the actor told her fans.

She said she was feeling particularly good and wanted to share the “kick” she gets from “moving”.

Abbas was quick to point out that moving did not just mean mundane household chores you would ordinarily be doing in your life like “driving a car [or] cooking food”.

Instead, what she meant by “movement” involved going out to a “designated place”.

The actor also said, “You never really get out of depression.” Instead, she contended, you learn to “understand it [and] work on it”.

Abbas said the idea was to understand how to “control your anxiety and your triggers” and to keep doing that.

She said there were a number of ways to do this, like “watching a good movie” or “talking to a good friend”.

She said that if even one person in her audience could connect to what she said in the video, that’s her good deed done for the day.

The actor has earlier been a strong voice on a number of mental health issues. She has talked about her own struggles with anxiety, spirituality and postpartum depression. She’s also urged women not to hurt themselves in attempts to look younger.

In a post on Instagram, the star highlighted the struggles she faces with her own skin and how her work and age led to acne breakouts.

Posting pictures of herself from before, during and after the breakout, Mobeen said her skin “went through a lot these last few months”.

She said a combination of harsh lights, daily makeup, wrong treatments and “just being in my early 20s with hormones” led to her developing “really bad acne”, which is “finally healing now”.

The actor said she didn’t look like the filtered pictures she posted on the internet, “but that’s because I am human”.

She went on to say that people face intense scrutiny online, especially “young women in the spotlight” and sometimes netizens “forget there are real people behind the pictures”.

Mobeen ended her note saying, “A little more kindness would go a long way.”

She isn’t alone here either. In 2019, Hania Aamir talked about the same scrutiny and mentioned feeling insecure about her own struggles with acne. She said her anxiety eventually led her to ask, “Why is my skin defining me? Who has made these beauty standards that we always feel the need to match?”

Echoing Aamir’s sentiments, Mehwish Hayat also said, “Flawsome is awesome.” The actor said that, “Away from the studio lights, the cameras and the glamorous makeup, we all battle with the same skin problems and insecurities as any other girl.”

Hayat urged girls in her line of work, Aamir included, to “embrace it,” calling it “part of being a woman”.

In 2021, Syra Yousuf faced trolls head on when they began to make fun of a barefaced picture her sister had posted. The star proceeded to post more of herself with the caption “I really like my skin. #NoFilter”

The change is evident on social media, where posts like Kylie Jenner’s TikTok uploaded last week quickly went viral.

“I’ve added a new favourite to my routine. Pomegranate-flavoured cutting jelly. This is not a typical jelly. It’s for digestion. My goal is to snack less for the new year. I’ve been bringing this everywhere,” she said, filming herself pulling a stick-type jelly supplement out of an Hermes bag and eating it in her car.

The message was clear: beauty routines are no longer limited to serums and creams. They now extend to functional foods and supplements designed to support digestion, skin and overall wellness — a category widely known in Korea as “inner beauty”.

Cardi B delivered a similar endorsement in December, praising the same type of “cutting jelly” on Instagram. Marketed as helping control post-meal blood sugar spikes and promote regular digestion, the product combines pomegranate concentrate with dietary fibre in a portable, single-serve format. “With this, I can eat whatever I want,” she said in the video, reinforcing the idea that beauty and body care are increasingly framed as lifestyle habits rather than cosmetic fixes.

Industry watchers see these celebrity shout-outs as a sign that inner beauty has entered its next growth phase. According to Kolmar BNH, the health-functional-food arm of Kolmar Korea, the global inner beauty market is expected to grow about two per cent annually through 2027, driven by rising interest in skin, hair and gut health. “Inner beauty products are gaining attention worldwide across multiple wellness categories,” the company said.

Search and sales data support the shift. On Korean beauty app Hwahae, October’s top global search terms included not only skin care but also supplements such as zinc and selenium. At Olive Young, the country’s largest beauty retailer, sales of inner beauty products rose 24pc among domestic customers and 49pc among overseas shoppers in the first 11 months of 2025 compared with a year earlier.

The collagen boom sits at the centre of the movement. “Collagen is king,” said Olive Kim, founder of supplement brands Cloud Cafe and Collagelee, noting that ingestible formats — from liquid shots and stick jellies to gummies and powders — are gaining favour as consumers seek visible skin benefits from within. Industry experts note that, because collagen molecules are difficult to absorb topically, many dermatologists and dietitians recommend oral supplementation to support elasticity and hydration.

Format matters as much as function. Fruity jellies, liquid shots and drinkable supplements are turning what was once a chore into a daily habit many consumers enjoy. As Korean-style holistic beauty gains popularity worldwide, the line between snack, supplement and skincare is increasingly blurred.

This story was originally published on The Korea Herald, an ANN partner of Dawn

Actor Nadia Afgan, who sees this happening around her all the time, posted a video on Instagram to challenge these practices and maybe talk some sense into people driving themselves and others mad in the pursuit of ‘perfection’.

Barefaced, with morning tea in hand, she boldly faced the camera to show what she looked like without makeup. She said her hands are “wrinkled” and “have spots on them”, one of her eyebrows “has a few grey strands”, and she’s got wrinkles under her eyes. Despite all of this, she said, “I think I am very beautiful, I am very confident with my skin and my face.”

Coming to today’s beauty standards, Afgan said, “the most beautiful, intelligent, talented young girls are made to worry about their looks. About extra fat on their cheeks [and] on their bodies”. She told the camera how newcomers are made to worry “about their height…their skin, their faces, their hair” and told, “If you want to become a heroine, if you want to land a lead role, you need to look a certain way.”

The actor said there was a need to relieve newbies of this “unnecessary pressure” and have them focus on their talent and acting ability. She told the young actors to “be comfortable in your own skin”, adding that nobody on TV has perfect skin, “there are tonnes of makeup, filters, great lighting”.

Afgan said she had gone through the same thing and would often complain to her husband about it. He asked her if she “wanted to look like everyone else” and gave her more strength to love herself. She said she tries to look after her physical and mental health by sleeping better and eating well.

The Sharpasand star said she’d gotten fillers under her eyes at one point, but later found out the bags under her eyes were a sign of Iron deficiency; supplements were all she really needed to make them go away. She also said that she tried to lose weight recently after gaining a bit during menopause, but not “because I wanted to look slender and dance around trees wearing a sari, I was genuinely worried for my joints and the threat of diabetes.”

Afgan said there was a need to “improve our beauty standards”. Adding that, “People are different and still beautiful. Everyone’s journey, surroundings, circumstances, experiences are different and that shapes them.” She asked viewers to accept themselves and others as they are and “not make a world where people say ‘oh, she’s pretty and she’s not’.”

For young stars, her parting words were, “Sure, look good, dress nice, just don’t starve yourself for the perfect figure.”

What is perhaps adding fuel to the fire is access to infinite information in the palms of our hands. Experts believe that overexposure to unregulated information can complicate how people process world events. For younger people, it has created a high-stress environment with many sharing similar experiences of feeling “triggered” or “overwhelmed”.

However, the discourse around media consumption may be overlooking the actual issue: the systems we live in are no longer working and the recurring feeling that something is not right may be a symptom of a larger problem. The business-as-usual formula is showing cracks as people, especially younger generations, increasingly express discontent towards the status quo.

But if people are unhappy with the status quo, why don’t things change? Besides all that pesky anxiety, living in an era of hyperawareness has pushed people into a state of freeze as they carry on with their daily lives amid systemic collapse. People acknowledge the need for structural change in society, but participate in those same structures every day.

While worrying can take many forms, it is important to look at this human response to the world because it has consequences for society in general.

That collective dissonance has a name — hypernormalisation.

What is hypernormalisation?

The term, originally coined by Alexei Yurchak to explain what civilians in Soviet Russia were feeling, is currently making the rounds on the internet. In his book Everything Was Forever, Until It Was No More, Yurchak described the final days of Soviet Russia, where society was unable to imagine alternatives to the status quo until eventually the system collapsed.

The term was subsequently used in a 2016 documentary by British filmmaker Adam Curtis. He narrated, “The Soviet Union became a society where everyone knew what their leaders said was not real because they could see with their own eyes that the economy was falling apart, but everybody had to play along and pretend that it was real because no one could imagine any alternative. One Soviet writer called it hypernormalisation.

“You were so much a part of the system that it was impossible to see beyond it. The fakeness was hypernormal.” His documentary focused on living in a “post-truth” society where political leaders created fake narratives and counter-culture became ineffective.

“We live in a world where the powerful deceive us. We know they lie, they know we know they lie, they don’t care. We say we care, but we do nothing. And nothing ever changes. It’s normal. Welcome to the post-truth world,” reads the on-screen text in the documentary’s trailer.

Can’t stop, won’t stop

Recently a video of digital anthropologist Rahaf Harfoush went viral in which she made use of the term. “What you are feeling is the disconnect between seeing that systems are failing, that things aren’t working… and yet the institutions and the people in power just are ignoring it and pretending everything is going to go on the way that it has,” she explained in the video.

“Hypernormalisation is when everyone knows that the system we’re living in doesn’t really work, but we all go along with it anyway because we can’t imagine what else to do. It’s like we’re participating in a collective illusion,” Rahaf told Images. “It’s become popular now because so many of us are experiencing that same feeling in our digital lives. We know our feeds are full of misinformation, we know our attention is being manipulated, and we know the stories we’re told about progress don’t always line up with reality. “But because these systems are so embedded in how we work, connect, and live, it feels almost impossible to step outside of them.”

She explained that people were drawn to the term because it illustrated the “uneasy sense” that something was not right and that everyone was complicit in “keeping up the illusion”.

Speaking about that dissonance, the anthropologist noted, “Many of us are in a kind of collective freeze; we know something is wrong, but we feel powerless to change it, so we default to maintaining the status quo. That’s where cognitive dissonance comes in: the gap between what we know and how we act.”

She described climate change as an example of this. According to her, despite easily available evidence about unsustainable lifestyles, people continued with “business as usual” because the alternatives felt overwhelming or inaccessible. “We live with that contradiction every day,” she said. This was also observable in people’s relationship with technology, according to Harfoush. People are aware that endless scrolling on their phones undermines their focus and well-being, yet they are locked in due to the design of these platforms and the pressure to stay connected, she explained.

“What I find fascinating as a digital anthropologist is how widespread this state has become. It’s not just individuals struggling; whole organisations, even governments, operate within these contradictions. We’ve normalised the freeze, even when the cracks are showing,” Harfoush said.

Aaron Mulvany, an anthropologist and professor at Habib University in Karachi, described the concept as when everybody in society can see that the structures and systems that are supposed to serve the nation are not functioning, “but they’re unable to imagine a way out of this repetitive cycle of reproduction of the system [and] systems not working“. He likened it to a treadmill we can’t get off.

In a conversation with Images, he maintained that hypernormalisation strictly applied to the conditions of the Soviet Union. “I’m convinced by the argument about the late communist Soviet Union, that’s what was going on. It had been going on for a very long time… I don’t see this part happening [elsewhere] yet right now,” he said.

“Things seem to work. People keep doing their daily business. But one of the other pieces that’s missing is a despair in daily life that there is no way out of this, and what I’m seeing as an American, watching my country from abroad, is that… that despair hasn’t infected the political system yet. You still see people who see a way out… That soul-destroying despair, ‘we can’t see a way out’ — for me doesn’t exist yet.

“It could take hold very quickly,” he warned, adding that since right-wing American political commentator Charlie Kirk was assassinated, something was happening “linguistically” which was “very concerning and could point the way towards the normalisation of hypernormalisation”.

“What is concerning is that I am not seeing the kind of pushback [that was expected], like the legacy media in the US seems to have rolled over and died.”

“There is a large population of the US that feels despair, 100 per cent. I can share that. There is an awful large, probably statistically, almost as large, population that thinks everything is going great. They are on board with this. For them, institutions are working. For them, the government is doing exactly what the government should be doing.”

He noted that in contrast, people on the “other end of the political spectrum do feel despair”. “But the reason that these are not shared in the same massive, nearly universal way that they were in the Soviet Union is because of the fragmentation of media through the rise of social media. We can exist almost entirely in our own little bubbles of reality.

“There are plenty of people, millions, literally millions of people in the US who look at the nation’s institutions and see them working. There are millions more people on the complete opposite spectrum who see institutions and see them failing and they have no idea what to do. These are the people who are thinking in terms of hypernormalisation.”

In Pakistan’s context, this can be observed in what Umair Javed, who teaches Sociology at the Lahore University of Management Sciences, calls the “politics of common sense”.

Explaining Antonio Gramsci’s concept and its subsequent use by Pakistani author Aasim Sajjad Akhtar, Javed described the idea as political structures being “too overwhelming” and the belief that they “cannot necessarily be changed in any meaningful way”. “So we need to make peace with it and to find a way through which we can extract some benefit for ourselves, because… systems of injustice, exploitation, chaos [and] turbulence are not necessarily going to go away anytime soon.”

Terming systemic dysfunction in Pakistan “chaos,” Javed viewed systemic issues as a driver of hypernormalisation. “The way that the state… interacts, people do not necessarily see a way out of the problem and they do not necessarily have a way of finding a solution to these very concrete and political problems… So in some ways, they have no option but to play along with it,” he said.

He added that playing along or the politics of common sense can, in turn, re-enable the state to remain in the existing “unresponsive and, to varying degrees, its failed form”.

Does it really matter?

Does any of this impact us? The short answer is yes, because hypernormalisation has consequences that go further than our individual lives. While drawing a parallel with the Soviet Union may not be entirely accurate, today’s world carries similarities that cannot be overlooked.

In May, Caroline Hickman, an American psychotherapist and instructor at the University of Bath specialising in climate anxiety, told The Guardian that people who felt the “wrongness of current conditions” might be experiencing depression and anxiety, but those feelings were “quite rational — not a symptom of poor mental health, alarmism or a lack of proper perspective”.

She was quoted as saying, “What we’re really scared of is that the people in power have not got our back and they do not give a s**t about whether we survive or not.”

People around the world have expressed discomfort with ‘business-as-usual’ attitudes in everyday life amid Israel’s devastating bombardment in Gaza following October 7, 2023, which killed well over 67,000 Palestinians. While witnessing the conflict through our screens is far from the mental trauma Palestinians have faced, seeing pictures and watching videos of dead children since the genocide began coupled with consistent inaction against Israel has caused widespread revulsion and evoked mistrust in systems of power.

The purpose of this essay is to discuss whether such feelings are merely a product of witnessing the state of the world or also emerge from the inability to imagine a different kind of world.

Speaking about the struggle to imagine alternative systems, Javed, the teacher at LUMS, said there are no existing political structures “people can engage with that will help them answer these questions and provide a pathway out or at least give them a framework to understand why the world is the way it is”.

He noted that since the 1990s, the world had converged on liberal democracy and international human rights as the preeminent framework for how the world was supposed to be run. “And then you suddenly start to see it… it always was a façade, but you start to see it completely exposed in the aftermath of the genocide in Gaza. So what is the framework beyond this? That’s what everyone is asking for.”

Reproducing same systems

When asked about implications beyond the cognitive level, digital anthropologist Harfoush said hypernormalisation can show up in “very material, tangible ways”. “When we normalise systems that are not serving us, it shapes our policies, our economies, and even the way we design our cities.”

She gave the example of modern work culture, saying, “We all know it’s unsustainable (burnout rates are skyrocketing, mental health is suffering), yet organisations still cling to outdated measures of productivity because we haven’t imagined new models that truly value creativity and wellbeing.

“That’s hypernormalisation at work: the façade of ‘business as usual’ hides the cracks that are already showing up in absenteeism, attrition, and declining innovation,” she said.

“So while hypernormalisation begins in our minds, in the stories we tell ourselves to make sense of contradictions, it absolutely manifests in the physical world, in policies, infrastructures, and lived experiences,” she explained.

According to Jorge Oliveira, a researcher in Australia, hypernormalisation can significantly impact democratic governance and social well-being. In an article titled Hypernormalisation: The Crisis of Post-Truth Society, he wrote, “When systemic dysfunction is normalised, citizens may become complacent, ceasing to question the status quo. This, in turn, enables political leaders to continue exploiting the system without facing genuine accountability.”

He added that when a society sidelines experts and favours simplistic political narratives, important issues such as climate change, healthcare, and economic inequality remain unaddressed, resulting in dire consequences. The article also discusses that that acceptance diminishes the foundation of public trust and the erosion of trust “makes it harder to mobilise collective action for meaningful change”.

In Pakistan’s case, people do not know what to situate their politics on, according to Javed. He argued that people were reacting to politics through mediated consumption in the form of social media content, which was shaping their “political socialisation”.

He explained the emergence of “deeply unsocialised political subject” as people who were only experiencing politics in a narrow, consumption-driven form, which was leading towards “disengaged citizenry” who cannot imagine alternatives or were not invested in making the state or politics more responsive.

Oliveira argued that it was hard to imagine an engaged citizenry because people were “just caught up in meeting their day-to-day subsistence requirements,” adding that they do not have much time for deeper political engagements. “All of the more fundamental issues of politics are basically put on a back burner because people are literally just trying to navigate their daily lives on a regular basis,” he wrote.

Can we do something?

The state of the world may be depressing, but there’s always hope for change. The concept of hypernormalisation can be useful because it helps us see the underlying issue and offers an opportunity to step outside the collective illusion towards actionable change.

According to Harfoush, “Once you can label an experience, you can start to work with it more intentionally.” Beyond the psychological relief, she said it also helps us diagnose where systems are failing. “If we realise that an entire industry is running on narratives that no longer match reality, that is a signal for leaders, policymakers, and citizens to intervene. It becomes a tool for critical thinking.

“So the concept is not just descriptive. It can be prescriptive too. It creates space to imagine alternatives and to start asking, ‘If this story no longer serves us, what might a better one look like?’”

When asked what we can do about hypernormalisation, she said the awareness from when people recognise the “gap between the story they are told and what they actually experience” creates “cracks in the façade”.

She spoke about practising small acts of refusal on an individual level by setting boundaries with technology, questioning productivity myths at work or choosing to engage with information more intentionally. “These actions may feel small, but collectively they signal a cultural shift,” she said.

It also means being willing to acknowledge when old narratives no longer serve us and having the courage to imagine alternatives, she said. This can be done by redesigning work to prioritise wellbeing or building new governance models for technology that actually reflect our values.

“So while hypernormalisation might always be part of the human condition, we are not powerless. Every time we choose to confront the contradiction instead of ignoring it, we open up the possibility of change,” Harfoush said.

Mulvany took a rather optimistic approach, saying he believed there are people imagining alternatives, particularly at the grassroots level. Highlighting various systematic issues in Pakistan, such as corruption, power outages and lack of access to clean water, he said, “There are plenty of other people who are imagining other ways the state could be. There’s not a hopelessness [that] ‘this is what we have and this is all we’re ever going to have.’ There are people and there have been since the 70s… who are able to imagine a different kind of Pakistan.”

The professor sees people who imagine alternatives all the time. “Every day, I spend time with students who are excited to make change. I talk with students who have ideas for how their neighbourhood can be changed, and how that change might be applied to the next neighbourhood, which could then be applied to larger systems across Karachi. I see students who are concerned about water issues, solid waste issues, general sanitation, health and epidemiology… about Afghan refugees, about higher education [and] lower education.

“I see students every day who are going out into their communities and trying to make a change. I see it every day,” he said, adding, “There are lots of people in Pakistan who still have hope.”

When Harfoush first posted the Instagram video, she made it “to reassure others that they are not alone” and that “they are not misinterpreting the situation or imagining things,” The Guardian reported. Understanding hypernormalisation “made me feel less isolated,” she told the publication.

While confronting the status quo can be a daunting task, the collective response indicates that we are not on our own. Understanding collective dissonance can help us actively respond to systemic failure and translate discomfort into collective action.

We can stop reproducing the status quo only after we break out of the illusion. Instead of following business-as-usual, we must allow ourselves to imagine and create better systems.

Digital creator by trade, husband to another influencer with-a-larger-following-than-himself by relationship status, father to a toddler, and a self-proclaimed victim to — wait for it — postpartum.

You don’t see the problem yet? Let me break it down.

What exactly is postpartum?

For those who may be unaware, postpartum refers to the period after childbirth that a mother goes through, as her body tries to recover from the massive trauma it underwent during pregnancy, delivery and beyond.

Etymologically, the word ‘postpartum’ comes from Latin, with “post” meaning “after” and “partum” meaning “birth”.

So no, Azlan, it cannot be taken as a philosophical birth; it specifically means the literal, physical act of giving birth.

I can go into the details of what exactly the process of giving birth entails, from which recovery is needed during the postpartum period. However, as important a topic as that is, it will likely make a lot of the people (read: men) reading this squirm in their seats.

And as much as I enjoy seeing the privileged feel uncomfortable at the mere mention of facts about the bodies and experiences of those different from them (which are things that should have been common knowledge by now anyway), I also need to be mindful of the restrictions posed by word limits and dwindling attention spans.

So, for now, let’s just briefly recap the few major components of this process for the education for all the Azlan Shahs out there.

The trauma a mother’s body carries

The uterus typically weighs 55 to 60 grammes pre-pregnancy, and by the time of delivery, it multiplies in size to nearly a whole kilogramme. That is between 14 to 20 times its original size.

During postpartum, it shrinks to return to its pre-pregnancy size and condition. This involves physical cramps (also known as “afterpains”), especially while breastfeeding.

Speaking of the uterus, its contractions are painful, yet important even post-delivery to prevent bleeding from becoming heavy enough that it escalates into postpartum haemorrhage.

Then come the hormonal shifts.

Delivery causes the body to undergo some of the rapidest hormonal drops in human biology. When pregnant, oestrogen rises to anywhere between 100 to 1,000 times the usual level, and progesterone rises by up to 30 times. After childbirth, both of these plummet sharply within just hours — with this rapid crash usually leading to emotional sensitivity, night sweats, temperature changes, depression, anxiety, vaginal dryness, and the all too common ‘baby blues’ experienced by an estimated 85 per cent of all mothers.

On the other hand, cortisol rises during pregnancy and usually declines after birth, though it may stay elevated in some women with chronic stress, nutrient deprivation or sleep disruption. Prolactin and oxytocin surge around delivery and during breastfeeding, supporting milk production, bonding, and uterine recovery.

These hormonal shifts, combined with the demands of newborn care (which disproportionately fall on the already exhausted mother’s shoulders, especially in Pakistan), create a complex mix of symptoms, such as fluctuating stress levels, fatigue, sleep changes, libido shifts, and altered affection. This is in addition to the largely-overlooked, unstable thyroid hormone that can cause postpartum thyroiditis and other complications.

All these hormones increase, decrease, and/or fluctuate naturally during and after childbirth, and some are further affected by lactation and environmental factors.

Imagine the uncertainty. The unprecedented pace of constant (and largely uncontrollable) change that the mother’s body goes through. And this is only the tip of the iceberg. We haven’t even touched upon labour pain, vaginal tearing/C-section surgery, mastitis, pelvic floor damage, or the multifaceted psychosocial stressors that are especially exacerbated in cultures such as ours — making a woman’s postpartum life harder than it already happens to be. Mind you, all of this is about the ‘normal’ postpartum period, which every single biological mother goes through. Meanwhile, the everliving ghost of postpartum depression continues to lurk as another possible form of struggle linked to motherhood, and a very common one at that.

Twenty-eight to 63pc of mothers experience postpartum depression in Pakistan.

“But what does Azlan Shah have to do with this?” Nothing, and yet, unfortunately, everything.

‘Postpartum for dads’

Last week, Shah made the absurd choice to put up a since-deleted carousel post on Instagram captioned, “Let’s talk about postpartum… for dads.”

Really? Did you give birth to the child?

“The Dad Version of Postpartum, the part no one talks about,” read the first slide, featuring a picture of him with his wife, Warisha Javed, who is holding their baby in her arms.

The 10-slide post moved through more such pictures of either the three of them together or of him alone with the baby, while one showed Javed alone on a hospital bed.

Many men don’t often post their partners and children online very much, so the opposite happening here could’ve been considered a small sign of healthy masculinity. However, Shah had other plans.

Instead, he chose to add accompanying text with each picture that sought to illustrate how supposedly difficult men have it when it comes to dealing with — yes, you guessed it right — postpartum.

What made it worse was how the post seemingly equated the very unique and stark physiological changes a mother goes through during pregnancy and postpartum, with the real yet nowhere near comparable emotional changes a father may experience during the same period.

If he really wanted to shed light on a father’s struggles with respect to new parenthood, he could’ve easily done so without misusing a term that doesn’t apply to him. The right term for that would be perinatal/paternal postnatal depression. The fact that he chose to instead hijack an issue that even mothers don’t get a fraction of support for screams attention-seeking laced with fragile masculinity and misogyny. “Because healing and support aren’t just for moms,” the post concluded by saying.

Theoretically speaking, this is absolutely true. However, we live in a country where countless mothers are expected to go back to looking like their pre-pregnancy selves within weeks and be responsible for all childcare and general domestic labour, even after going through nine months of life-altering bodily changes. Conversely, it is quite socially acceptable for fathers to not share the labour of changing diapers and taking care of the baby’s (or his partner’s) other needs, and still receive praise and support for the minuscule effort of participating in conceiving the child and (sometimes) looking after the financial needs of the family.

In this environment, does it not feel like a slap in the faces of mothers to first go through all that they do, not get enough community support to deal with it, and then be robbed of the one word that is meant to give their distinctly difficult early experiences a name?

It feels like an exercise in futility and needless frustration to quote every single sentence from Shah’s post and explain why it doesn’t make any sense, so I will not do that. Instead, what I will do is ask the men reading this: why do you feel the need to hijack issues that have nothing to do with you?

Why do you feel threatened when women take the initiative to publicly talk about problems that they are either solely or disproportionately affected by, especially to the extent that you end up centring yourself in that discourse?

I am all for men being vulnerable and seeking support, but it cannot happen at the cost of trivialising the horrors that women often have to go through in those situations.

In a society where men already feel like they are doing their wives — and, perhaps, women in general — a favor by so much as pouring themselves a glass of water every once in a while or by ‘babysitting’ their kids to ‘help’ their wives singlehandedly take on what should be the partnered job of parenting, social media posts like Shah’s further recede the bar of expectations women are socioculturally allowed to hold from men.

Proof of this lies in a comment made by his wife on the same post, glorifying her husband’s half-baked take.

Then there are the accusations that Shah copied the entire post without giving the original creator credit, which if true, meant that he took both a word that does not belong to him but also someone else’s ideas and intellectual (no matter how half baked) effort. At this point, the bar is truly 350 feet underground.

Chasing clout

The thing about gender roles and social conditioning in a patriarchal environment such as ours is that when a woman is shamed for doing something supposedly wrong, she more often than not has enough humility to apologise.

She apologises even when she shouldn’t — which applies frequently, because women are often shamed just for existing rather than doing something ethically wrong.

On the other hand, men often not only commonly lack this humility but also possess the uniquely unwanted and perverse talent of doubling down on their problematic behaviours.

This point of sociological analysis bears relevance here because Azlan Shah is proving to be a living example of it.

Mere days after being rightly shamed into taking down the postpartum post from Instagram (while still keeping it up on Facebook) and being criticised elsewhere online for posting it in the first place, we already have something new to be mad at him for.

Taking to his Instagram stories recently, he shared an “important” announcement: “I am getting married again”.

A desperate “My wife has consented to it” followed this explosive statement. Perhaps the desperation lay in the entire story itself. Desperate for attention, for views, for clicks, clout and celebrity page speculation.

With social media being an integral enough part of so many people’s lives that there’s the “attention economy” exists, I get why content creators want attention, views, clicks and clout. These things fuel their lifestyles, and trying to earn money to live comfortably is as basic a desire as it gets, which isn’t a problem. The problem arises when their content becomes problematic, and Shah’s content has become problematic.

It is content aligned with patriarchal notions, wrapped in a layer of feminist concepts like consent and men’s mental health in order to avert backlash over what he’s saying.

I could go deeper into this analysis, but here comes another plot twist: Shah isn’t actually engaging in polygamy, at least not filhaal. He announced along with his wife through a video posted two days ago that his story on this topic was referring to getting “remarried” to his first and only wife, on account of their third wedding anniversary coming up.

Oh wow! A joke so good, I can totally see a career for him in stand-up comedy — because all the people of decent mental capacity would surely stand up and walk out of the room upon hearing such tasteless humour!

It is nearly the end of 2025 — when will men start learning that patriarchal pranks are not funny? Announcing that you are getting remarried, with or without your wife’s consent, is not a new sport for Pakistani men, and for Shah to chase clout by treating such a serious issue as a frivolous prank makes one question the standard we’ve set for men across the board, because if Shah, as a man who claims to love his wife, is resorting to such misogynistic and lazy self-promotion tactics, how abysmal must the state of other not-so-nice men be?

It is a question that men like Shah, and those worse than him (which exist aplenty), must reflect on if they want to keep the hope of ending up with a woman alive. Because, as I type this, Pakistani women are posting comments calling out Shah for his insufferability — with some jokingly hypothesising this being a consequence of his ‘postpartum’.

Amidst this entire fiasco, one positive thing has emerged — we are finally seeing women in greater numbers having the political consciousness required to recognise such inexcusable attention-seeking endeavours for what they really are, which is in large part thanks to the thankless labour of feminist movements worldwide, especially those in Pakistan.

While it remains to be seen whether the reaction to his post and ‘joke’ will stop him from posting anymore embarrassing takes for the foreseeable future, what matters more is that many women are seeing through the performance — and they’re done applauding.

It’s Monster’s attempt to carve out space in the booming wellness-adjacent, female-targeted functional beverage market, but the premise itself has already sparked confusion, and a whole lot of “why is this even a thing?”

The drink launches with four flavours — Strawberry Fling, Guava Lava, Berry Tempting and Sunset Squeeze — all boasting a zero-sugar formula, no artificial colours and a rather hefty 200mg of caffeine per can. On its website, FLRT positions itself as “your new crush in a can,” and the internet is already rolling its eyes.

One X user wrote, “female focused… named FLRT… berry tempting, strawberry fling and sunset squeeze… oh we’ll never be free.”

Another couldn’t understand why the company thought Monster didn’t appeal to women.

The naming conventions, combined with the pastel-heavy visual identity also raised eyebrows.

Others questioned the premise altogether.

But the strongest criticism highlighted a larger systemic issue in branding and “female-first” marketing. As one user put it:

The brand isn’t just pushing aesthetics, it’s also promoting a suite of functional benefits — the drink will apparently provide collagen support, immunity support and skin and hair support. According to Monster, FLRT was born out of the idea that energy should be “as vibrant, fearless, and fun as the women who drink it,” built using “better-for-you ingredients”.

Long associated with extreme sports and aggressively masculine branding, Monster’s FLRT signals its attempt to court a demographic that it believes wants fun with function. However, as X users pointed out, the execution is not in the best taste. So whether FLRT will resonate with women or become another cautionary tale in “shrink it and pink it” marketing, remains to be seen.

The singer shared a video to his Instagram page on Friday in which he spoke about the emotions he felt after a recent Call performance in Lahore. During the performance, the band performed two “very important” songs — ‘Laree Chooti’ and ‘Sab Bhula Kai’.

“They’re important or valuable because we’re very emotionally connected to them,” Khan explained. “We hugged it out on stage because we’d performed after quite a while as a band. We came backstage and Xulfi was talking about what he felt, Sultan was too — and I was quiet, trying to act normal,” Khan recalled. His bandmates even asked him why he was so quiet at the time.

Two days later, he was sitting at home and watching a video of the same performance when the dam broke and he couldn’t hold himself back. “I realised after that we men do not have the licence to really express ourselves. We train ourselves over the course of years to be strong and not really be vulnerable in front of people,” he shared.

Khan said he chose not to let out his emotions while performing, because he felt that he wouldn’t have been able to get back on stage and perform if he had let go emotionally. “But at home, in a comfortable space, when I was sitting and experiencing the performance I saw what the audience felt, what I felt, while writing that song and performing that song, it was overwhelming and I had to let it out.”

He said it’s unfortunate for men that at some point, they don’t have the licence to express themselves. “We bottle [up] our emotions, we look for that safe space where we think no one will judge us or view us as weak,” Khan said.

“I say, one should let I out — alone, anywhere, in front of people you really trust, we should not train ourselves to bottle up our emotions, we should just let it out, it’s very comforting, reliving, makes you feel free, that’s what I felt after seeing myself performing with my friends after a while.”

He ended his video with a message to all the men watching: “So guys, we have that pressure of being strong in front of people, in front of family, but it’s good to just let it out at times.”

He captioned the post, “We, as men, are taught to bottle up our emotions to maintain the perception that we are strong. I’ve been guilty of doing the same. To all the boys out there; I know we’re constantly under pressure to never look weak, but trust me, expressing yourself is one of the truest forms of strength. Whether you let it out alone or in front of the people you trust, it’s liberating.”

He also reminded his followers that vulnerability doesn’t make anyone less of a man. “It makes us human. The moment we allow ourselves to feel, we stop carrying the weight alone. That’s when real strength begins.”

Taking to Instagram, the actor and UNICEF Pakistan’s first National Ambassador for child rights shared a moving message about the importance of talking about mental health — especially when it comes to children. In a short video, she urged everyone to listen more, care deeply, and start normalising conversations that are too often brushed aside.

“We don’t talk about mental health enough,” she said. “And when we do, it’s often whispered, as something to hide, but it’s not. Mental health is just as important as physical health.”

In her message, Saba spoke candidly about her own journey. She revealed there were days that felt “heavy” and times she didn’t know who to turn to — but healing came from reaching out, talking about her feelings, and embracing small, grounding routines.

“For me, praying, journaling, reading, exercising, painting, and even listening to music — these are habits that keep me calm,” she shared.

Her message was also a gentle call to parents, teachers, and mentors to pay attention to children’s emotional worlds.

“Sometimes, just listening to a child or validating their feelings can make the biggest difference,” she said.

Saba’s partnership with UNICEF Pakistan continues to spotlight child mental health — an issue that’s still surrounded by stigma in many communities. With her latest message, she’s using her platform to remind everyone that healing starts with empathy and connection.

“Let’s keep talking, let’s keep listening, and let’s keep reminding each other — it’s okay not to be okay.”

She also added a disclaimer to her post, reminding viewers that her content is for informational purposes only and not a substitute for medical advice. “If you notice any persistent changes,” she wrote, “consult a healthcare professional promptly.”

In the video, Malik explained that ovarian cancer is often difficult to detect because its early signs are subtle and easily mistaken for minor issues. “A lot of people have asked me about the symptoms of ovarian cancer,” she said. “As I have mentioned earlier, it’s known as a silent cancer.”

She described some of those deceptively ordinary symptoms: bloating, loss of appetite, sudden weight loss or gain, constant fatigue, back pain, and frequent urination. The Mayo Clinic and Cleveland Clinic also list these as symptoms of ovarian cancer.

For women over 40, she added, any irregularities in the menstrual cycle — such as excessive bleeding or changes one might attribute to menopause — could also signal ovarian cancer. These, she said, are signs many women tend to ignore because they seem “too generic, almost like an upset stomach” that come and go.

Malik went on to explain that while these symptoms can be confusing, there are tests that can offer some clarity. One of them is the CA-125 test, a blood test that checks for the presence of a protein called cancer antigen 125. Elevated levels of CA-125 can indicate ovarian cancer, though not always. “Your normal has to be below 35,” Malik explained. “If it’s beyond that, then you have something to worry about.”

According to the Mayo Clinic, a CA-125 result above 35 U/mL may suggest cancer, but benign conditions such as endometriosis, pelvic inflammatory disease, or even menstruation can also raise the level. The test can also return normal results in the early stages of ovarian cancer, which is why it’s often paired with a pelvic ultrasound.

“CA-125 isn’t 100 per cent accurate,” Malik cautioned. “If you have any of these symptoms, you should also get a pelvic ultrasound done.”

She recounted how she missed the signs. “What happened to me was, I was travelling and I had a feeling of being bloated. I thought it was something that happens when you travel, and I ignored it. Two months later, when I came back to Pakistan, the bloating did not go away. Then I got this test done, and my CA-125 was above 2,000, which is scary, because it should be less than 35.” Not long after, she was diagnosed with stage 3C ovarian cancer.

Her voice in the video is calm but resolute, and it’s clear that sharing this isn’t easy for her. “The purpose of my sharing this with you,” she said, “is to spread awareness. If you are suffering from any of these symptoms, get tested. It’s a simple test; they’ll take your blood, and the next day you’ll get the result. And if your CA125 levels persist to be higher than normal, get an ultrasound done. Don’t ignore anything out of the ordinary. Listen to your body. I do not want anyone to go through what I have gone through and am going through. Don’t ignore your health and these symptoms.”

By speaking so openly about her own diagnosis, Malik is doing what many in her position might shy away from — using her platform to save lives. Her message is simple yet vital: pay attention, act early, and never underestimate what your body is trying to tell you.

In a dire report, Unicef projected that nearly one in 10 individuals within that age group will be living with the chronic disease in 2025, fuelled by easy availability of ultra-processed foods “even in countries still grappling with child undernutrition”.

Today, “when we talk about malnutrition, we are no longer just talking about underweight children,” Unicef chief Catherine Russell said in a statement on the report’s release. “Ultra-processed food is increasingly replacing fruits, vegetables and protein at a time when nutrition plays a critical role in children’s growth, cognitive development and mental health.”

The fight to reduce world hunger is bearing fruit in some areas, with the prevalence of underweight youths on a downward trend, falling from 13 per cent to 10pc between 2000 and 2022 among 5-19 year olds, according to data collected in 190 countries. However, over the same period, overweight numbers in the age range have soared, doubling between 2000 and 2022 from 194 to 391 million.

The spike is even more pronounced for obesity, a more serious form of overweight associated with metabolic disorders such as diabetes, certain cancers, anxiety and depression. In 2022, 8pc of those aged five to 19 worldwide, or 163 million, were obese, compared to 3pc in 2000.

Failure of society

Given the distinct trends, Unicef believes “a historic turning point” was reached this year, with the global prevalence of obesity at 9.4pc of the age group surpassing that of underweight, at 9.2pc. According to the projections, 188 million children and adolescents are obese.

Unicef bluntly described the primary culprit not as poor nutrition decisions by families, but unethical business practices designed to generate profits. Children “are being bombarded by… unhealthy food marketing of junk foods,” especially at school where they are exposed to sugary drinks and salty snacks, Katherine Shats, a Unicef legal expert in nutrition, told AFP. Such products are often cheaper than fresh foods like fruits, vegetables and proteins, which are being steadily replaced in families’ diets.

Unicef stresses the fault lies neither with children nor their families, but “a failure of society to protect the environments that children grow up in”. It also criticized what it called the false narrative that participating in sports can offset unhealthy diets. “It is impossible to ‘outrun’ the health consequences of a diet high in free sugars, refined starches, salt, trans-fats, harmful additives and excessive energy through physical activity alone.”

Urgent measures

Historically, levels of overweight have been higher in more developed nations. They remain high for example, in Chile, at 27pc in the five to 19 age group, and in the United States at 21pc. But since 2000, the gap between rich and poor countries has narrowed, with obesity rates soaring in some Pacific islands, where imports are replacing traditional products. In tiny Nieu, the age group’s obesity rate has reached 38pc, with the Cook Islands topping 37pc.

For some nations, it is a double curse as they grapple with both undernutrition and growing obesity. Shats laments that in certain conflict zones or areas with humanitarian crises, large food and beverage companies are taking advantage of such situations and donating ultra-processed foods to promote their own image and their marketing tactics.

So while children lack the availability of nutritional food, what they do gain access to is “this very unhealthy food because of these really predatory tactics from the industry,” she said. Unicef is urging governments to take binding measures, including advertising restrictions, taxes on sugary drinks and unhealthy foods, and policies that encourage the production of fresh produce.

More than 3.7 million people died from illnesses related to being overweight or obese in 2021 according to WHO figures — more than top infectious killers malaria, tuberculosis and HIV combined. However the sky-high prices of GLP-1 drugs, which can cost over $1,000 a month in the United States, have raised concerns they will not be made available in poorer nations where they could save the most lives.

On Friday, the WHO added semaglutide — the active ingredient in Danish pharma giant Novo Nordisk’s Ozempic and Wegovy — and the tirzepatide used in US company Eli Lilly’s Mounjaro to its list of essential medicines for adults worldwide. To ensure these “life-saving” injectable drugs reach people who need them most, the UN agency said in a statement it encouraged “generic competition to drive down prices”.

Andrew Hill, a pharmacology researcher at Liverpool University, pointed to research showing that generic semaglutide could be mass produced in India for as little as $4 a month. “What we’re asking is for Novartis and Eli Lilly to do the responsible thing and make their treatments available on a worldwide scale at an affordable, generic price,” he told AFP.

The patent for semaglutide will run out in some countries including Canada, India and China next year, which could also result in a surge in generic production.

GLP-1 drugs, which have some side effects including nausea, were originally developed for diabetes, but research has increasingly suggested they could help with a broad range of health problems including addiction. A study published in the JAMA medical journal this week found that patients with heart problems taking the drugs had more than a 40 percent lower risk of being hospitalised or dying prematurely.

One in eight people worldwide are now obese, while in 2022 more than 800 million people were living with diabetes, according to the WHO. The organisation also named a range of cancer drugs to its essential medicines list.

Alongside Saeed, the show also featured Karachi South ASP Nida Junaid, and clinical psychologist Dr Uzma Ali, who broke down how unchecked mental health struggles can escalate to extreme situations when left untreated.

Saeed, however, spoke directly to the root of the issue: the lack of preparedness among many parents who take on the responsibility of raising children without first addressing their own mental, emotional and relational readiness.

“Most people in our country aren’t capable of parenting. Not every couple deserves a child. Not every couple at every point deserves a child. Because are they themselves prepared for that child? Is their relationship sorted? Do they know each other enough? Are they mature enough to cope with problems and responsibilities?” she asked.

Yasir noted how societal pressures often push couples in the opposite direction, saying, “Here, we are told the opposite, that if the husband and wife don’t get along, they should have a child so they start getting along.”

To this, Saeed responded with a pointed critique: “Because we want to tie them together with a responsibility that they’re not able to or equipped to take.“

She added, “A person who can’t even be responsible for themselves, a person who is already dealing with issues, and people here don’t even go to mental health professionals, how can that person take on the responsibility of a child? Even if their mental health symptoms are manageable. I have seen so many well-educated people say things like they don’t believe in mental health, and how can someone fix you just by talking to you?”

Dr Ali also highlighted that we are all human and prone to making errors based on our ability to understand things. “We all have emotions,” she said. “We all learn how to cope with those emotions, healthy or unhealthy, by looking at the people around us, and in some families, people don’t know how to regulate their unhealthy emotions, so children don’t know how to regulate them either.”

Saeed’s comments echo what many people have long been stressing: until Pakistan normalises seeking therapy, acknowledges that mental illness is real, and breaks free from stigma, tragedies like these will continue to surface.

Parenting, Saeed argued, isn’t just about providing food and shelter; it’s about having the emotional capacity to nurture another life, something that cannot be done when one is struggling to cope with their own.

The conversation was a rare moment of mainstream television tackling mental health not as a taboo but as a social necessity. And it highlighted what Saeed put most plainly: before bringing children into the world, parents must first ask if they are ready — mentally, emotionally and relationally — to take on the responsibility.

This story of a cervical cancer survivor and mother of four from India, narrated in a World Health Organisation (WHO) report, is not unique. Cervical cancer is the fourth leading cause of cancer deaths among women around the world, especially in low- and middle-income countries such as India and Pakistan.

But here’s what many people don’t know — the disease is one of the few cancers that can be almost entirely prevented with early screening and vaccination. There are two approved vaccines that can reduce the risk of cancer by protecting against the infections that cause them — the hepatitis B vaccine and the cervical cancer or human papillomavirus (HPV) vaccine.

Pakistan is launching its first-ever cervical cancer prevention vaccine drive this month, and doctors and government officials are pushing to make it a success.

Virtually all cervical cancers are caused by persistent infection with HPV. Two high-risk types, HPV 16 and HPV 18, are responsible for 70 per cent of cases.

In 2006, the United States Food and Drug Administration approved a vaccine to be administered to females nine through 26 years of age. Gardasil, as the vaccine was called, aimed to protect from diseases caused by certain types of HPV, including cervical, vulvar, vaginal, and anal cancers as well as genital warts.

Nearly four years after its licensure, researchers who surveyed vaccinated women aged 14 to 59 found that among vaccinated girls aged 14 to 19 years, vaccine-type HPV prevalence dropped from 11.5pc to 5.1pc — a staggering decline of 56pc. Among other age groups, however, the prevalence didn’t seem to differ significantly.

In 2020, the WHO launched a global strategy aiming to accelerate the elimination of cervical cancer as a public health problem. By 2023, around 140 countries introduced the HPV vaccine into their national immunisation programmes, including those with large populations and cervical cancer burden, such as Bangladesh, Indonesia, and Nigeria.

In Pakistan, however, the vaccine has largely remained out of reach and unknown to most people — until now.

In August, the WHO announced that it is partnering with the Government of Pakistan to train over 49,000 health workers for the country’s first HPV vaccine drive, planned from September 15 to 27. The campaign is being described as a “historic milestone,” and is set to target 13 million girls aged nine to 14 years across Punjab, Sindh, Islamabad Capital Territory, and Azad Jammu and Kashmir.

The Federal Health Ministry announced that it is launching the campaign in Sindh in collaboration with the provincial health department and urged close coordination with the education department to ensure as many girls as possible are covered in the campaign. Sindh Health Secretary Rehan Iqbal Baloch said the campaign aims to vaccinate about four million girls in the province.

Gavi, a global health alliance that helps lower-income countries access vaccines, is also providing support, he explained. The necessary doses will be available free of charge through the government-led Expanded Programme on Immunisation (EPI).

Why is the drive important?

According to infectious diseases epidemiologist at the Aga Khan University Hospital in Karachi, Dr Muslima Ejaz, the initiative is important because it targets adolescent girls, a group often left out of health interventions. “By reaching them early, before they’re exposed to HPV, we’re literally safeguarding their future health,” she told Images.

She explained that the drive sets a precedent. If Sindh succeeds, it can become a model for scaling up across other provinces. “This campaign is not only about vaccination, it’s about building systems, community trust, and a roadmap for integrating HPV into routine immunisation,” she said. Essentially, it’s a public health breakthrough for women in Pakistan.

Gynaecologist Dr Uzma Chishti said adolescent immunisation is crucial, noting that although cervical cancer has traditionally affected women who are in their 40s to 60s, she has recently seen patients in their 30s.

She pointed out that the WHO now endorses a single-dose schedule, which simplifies delivery and increases the likelihood of uptake. While skepticism towards vaccines in general poses a challenge, she argued that it can be overcome with the right communication.

“Healthcare workers need to build trust, explain the disease, and highlight how vaccination protects girls before they are ever at risk,” she said, adding that counselling on preventive measures such as delaying early marriage and promoting safe practices is equally important.

Beyond vaccination, Dr Chishti highlighted screening as another critical tool. Simple tests such as pap smears or HPV testing can detect precancerous changes years before cervical cancer develops.

The rollout

Dr Sohail Raza Shaikh, additional project director of EPI Sindh, explained that the campaign will use a multi-pronged strategy, including fixed-site services at existing EPI centres, outreach programmes for communities unable to access those sites, and mobile vaccination teams.

Schools are expected to serve as the main vaccination sites, supported by the province’s education department, which has already trained teachers and conducted sensitisation workshops. Dr Shaikh added that around 48.5pc of the target population is enrolled in schools, while the remaining out-of-school girls will be reached through the Lady Health Worker programme and civil society organisations such as HANDS and the Sindh Rural Support Organisation.

He explained that approximately 3,611 vaccinators will take part in the drive, each working in a four-member team with assistants and social mobilisers, bringing the total to over 14,000 field workers. Supervisory structures are also in place, including 1,190 first-level supervisors, mostly doctors trained to handle adverse events following immunisation, and 393 second-level supervisors. A breakdown of the vaccinators includes 490 fixed-site workers, 2,990 outreach workers and 31 mobile teams.

To monitor coverage, the campaign will use the Sindh Electronic Immunisation Record (SEIR) system, with an additional HPV-specific module, along with vaccination cards distributed to recipients.

“Even after the campaign period, there will be a catch-up drive to vaccinate any missed children,” Dr Shaikh told Images. He stressed that the vaccine would become a routine part of the immunisation programme, with the Sindh government already having allocated budgetary resources for the next three years.

He highlighted the key role of teachers and parents in ensuring the success of the campaign. “Teachers, in particular, hold significant influence. If they support the vaccine, parents are more likely to follow,” he said. Districts with higher proportions of out-of-school girls, such as Kashmore, Qambar-Shahdadkot, Shikarpur, Larkana, Umerkot, Tando Muhammad Khan and Badin, are being prioritised for intensified mobilisation efforts.

Potential roadblocks

Epidemiologist Aneela Pasha noted a potential challenge for the drive: while the EPI mainly administers vaccines for infants and toddlers, such as polio, BCG and typhoid, the HPV vaccine is different as it targets adolescent girls, a group that does not routinely visit paediatricians.

She said myths related to the vaccine causing infertility might become a key hesitancy driver. However, she noted that the vaccine actually protects you from infertility because “it’s the HPV infections that could compromise your reproductive system”.

She also highlighted the prevalence of cervical cancer in Pakistan, with more than 5,000 women diagnosed annually and over 3,000 losing their lives to the disease.

Up-to-date figures are difficult to obtain from the Global Cancer Observatory due to the absence of a comprehensive national registry. However, data compiled by Islamabad’s National Institutes of Health from various registries between 2015 and 2019 shows cervical cancer is the fourth most common cancer among women in the country.

While misinformation and vaccine hesitancy are genuine concerns, paediatrician Dr Fyezah Jehan said the vaccine’s relative unfamiliarity might work in its favour. “No information is better than incorrect information,” she said.

Since widespread misconceptions have not yet taken root, health authorities have an opportunity to shape the narrative with accurate messaging. She warned, however, that misinformation could emerge once the campaign begins, making its management, and the timely delivery of correct information, critical to its success.

Influencers on platforms including TikTok and X are fuelling a growing wellness obsession popularly known as “sleepmaxxing,” a catch-all term for activities and products aimed at optimising sleep quality.

The explosive rise of the trend — generating tens of millions of posts — underscores social media’s power to legitimise unproven health practices, particularly as tech platforms scale back content moderation.

One so-called insomnia cure involves people hanging by their necks with ropes or belts and swinging their bodies in the air.

“Those who try it claim their sleep problems have significantly improved,” said one clip on X that racked up more than 11 million views.

Experts have raised alarm about the trick, following a Chinese state broadcaster’s report that attributed at least one fatality in China last year to a similar “neck hanging” routine.

Such sleepmaxxing techniques are “ridiculous, potentially harmful, and evidence-free,” Timothy Caulfield, a misinformation expert from the University of Alberta in Canada, told AFP. “It is a good example of how social media can normalise the absurd.”

Another popular practice is taping of the mouth for sleep, promoted as a way to encourage nasal breathing. Influencers claim it offers broad benefits, from better sleep and improved oral health to reduced snoring.

But a report from George Washington University found that most of these claims were not supported by medical research.

Experts have also warned the practice could be dangerous, particularly for those suffering from sleep apnea, a condition that disrupts breathing during sleep.

Other unfounded tricks touted by sleepmaxxing influencers include wearing blue- or red-tinted glasses, using weighted blankets, and eating two kiwis just before bed.

‘Damaging’

“My concern with the ‘sleepmaxxing’ trend — particularly as it’s presented on platforms like TikTok — is that much of the advice being shared can be actively unhelpful, even damaging, for people struggling with real sleep issues,” Kathryn Pinkham, a Britain-based insomnia specialist, told AFP.

“While some of these tips might be harmless for people who generally sleep well, they can increase pressure and anxiety for those dealing with chronic insomnia or other persistent sleep problems.”

While sound and sufficient sleep is considered a cornerstone of good health, experts warn that the trend may be contributing to orthosomnia, an obsessive preoccupation with achieving perfect sleep.

“The pressure to get perfect sleep is embedded in the sleepmaxxing culture,” said Eric Zhou of Harvard Medical School.

“While prioritising restful sleep is commendable, setting perfection as your goal is problematic. Even good sleepers vary from night to night.”

Pinkham added that poor sleep was often fuelled by the “anxiety to fix it,” a fact largely unacknowledged by sleepmaxxing influencers.

“The more we try to control sleep with hacks or rigid routines, the more vigilant and stressed we become — paradoxically making sleep harder,” Pinkham said.

Beauty over health

Many sleepmaxxing posts focus on enhancing physical appearance rather than improving health, reflecting an overlap with “looksmaxxing” — another online trend that encourages unproven and sometimes dangerous techniques to boost sexual appeal.

Some sleepmaxxing influencers have sought to profit from the trend’s growing popularity, promoting products such as mouth tapes, sleep-enhancing drink powders, and “sleepmax gummies” containing melatonin.

That may be in violation of legal norms in some countries like Britain, where melatonin is available only as a prescription drug.

The American Academy of Sleep Medicine has recommended against using melatonin to treat insomnia in adults, citing inconsistent medical evidence regarding its effectiveness.

Some medical experts also caution about the impact of the placebo effect on insomnia patients using sleep medication — when people report real improvement after taking a fake or nonexistent treatment because of their beliefs.

“Many of these tips come from non-experts and aren’t grounded in clinical evidence,” said Pinkham. “For people with genuine sleep issues, this kind of advice often adds pressure rather than relief.”

The study, conducted by researchers from Australia, Spain and the UK, reviewed past papers for correlation between levels of exercise and risk factors of various ailments such as cardiovascular disease, cancer, type 2 diabetes, depressive symptoms and dementia.

Taking a baseline of 2,000 steps, which is something most adults manage even without taking extra time to exercise, the study compared the reduction in rates of disease incidence. The findings indicate that those who walk 7,000 steps are 47 per cent less likely to die of cardiovascular disease and 37pc less likely to die of cancer. The same group has a 25pc lesser chance of developing cardiovascular disease in the first place and a 14pc lower risk of diabetes.

Compared to this, those who completed their 10,000 steps were only marginally less likely to develop these diseases, the differences being in single digits. The study even found that the more active group was very slightly more prone to dying from cardiovascular disease.

On the mental health front, the study found those who exercise had a 38pc lower chance of exhibiting depressive symptoms and a 22pc less chance of developing dementia. They also found that the 7,000-step group had better balance and coordination, being 28pc less likely to suffer falls; this number went down for those walking over 10,000 steps a day.

Another 2019 study by Japanese and US researchers found a similar peak benefit point at 7,500 steps; the same paper said walking backwards was more beneficial for cognitive ability and coordination. A 2011 paper from the University of Nevada backed up the correlation between brain health and backward retro walking; it also said walking backwards strengthens hamstrings and reduces pain in the lower back.

The advent of digital journalism has eliminated temporal restrictions on receiving news; no longer do you have to wait patiently for the next day’s paper. Or receive a messenger at your doorstep narrating how half your state was annexed while you had the most ordinary day of all time. Our generation has never experienced that — we’ve only known how to scroll for hours, anywhere and anytime, trying to process as much global news as we can at once, since everybody’s in a race to make sure they’re more aware than anybody else in the room.

Psychotherapist Shafa Rashid from Synapse, a Karachi-based neuroscience institute, told Images, “The cumulative emotional and sensory dysregulation resulting from constant exposure to distressing and tragic news at such a tender age, especially when these anxieties are not adequately addressed by their surrounding environment, but enhanced instead” complicates how people process these events. “This dysregulation and heightened sensitivity of their nervous system is what many teenagers unfortunately carry with them into their twenties,” she added.

“The pressure to have the right opinion” and constantly thinking about how to say the right thing, whether to say anything at all or whether you’ll be cancelled or embarrassed for saying one thing or the other is one of several reasons that create a high stress environment for young people.

Today, awareness has transformed into hyperawareness as minute-by-minute updates on everything from the US electoral campaign to a local influencer’s dog’s digestive issues are a single tap away. While this easy access to news helps us stay up to date on the atrocities being committed around the world, making it easier to raise our voices, recognise political propaganda and hold the right people accountable, it is also an immense burden on our sensory systems and causes burnout.

The issue lies not with the availability of news but with its endless nature. From the Palestinian genocide to the one in Congo, the much delayed controversial Pakistani election, the regime overthrow in Bangladesh, the PTSD triggering return of Donald Trump in the White House, the Pakistan-India war or the Iran-Israel conflict— the doomscrolling is never-ending, precisely because the doom around us is never-ending.

Clinical psychologist Afrah Arshad, founder of Teen Therapy Wellness, told Images that frequent exposure to tragic information can lead the brain to go into emotional overload, initiate a defence mechanism and lead to emotional numbness and detachment. Many teenagers have shared similar experiences of feeling “triggered” and “overwhelmed”.

A sensory overload

Romman Adil, a 19-year-old writer who has penned heartfelt poems for the Palestinian resistance, said that at one point, “seeing numerous reels and posts took a toll on me, and there have been occasions where I have cried and felt hurt for them”. People on internet platforms such as Reddit have shared similar sentiments of emotional arousal.

A forum on Reddit dedicated to Pakistani teens, TeenPakistani, saw similar reactions during the Indo-Pak conflict.

However, this fatigue isn’t exclusive to any one nationality; people across the world share these sentiments.

This doesn’t mean that we have been sentenced to some form of intense torture, but it does hamper our ability to process future atrocities. Especially when we witness graphic media of bloodshed, bombings, burnt bodies, and amputated children over a casual cup of coffee, and study for A-level exams while listening to news of missile attacks destroying geography-defying structures like the Lahore Port, living quasi-dystopian lives.

Over the course of the past two years, many younger people have simply become desensitised to tragic news and those who used to regularly share updates and resources for help now do it less often.

Rahim*, an 18-year-old from Lahore, shared what made him post less frequently, “It’s been going on for so long, I feel like a few story reposts don’t make a difference anyway. When I would post constantly, my Instagram got overloaded with pictures of beheaded babies and people burning alive. Then my exams started, I would open the app after a long day to unwind, and couldn’t bear to look at it. It only made me feel depressed — I know it’s selfish, but it’s what I felt.”

Many teenagers, including Rahim, also feel that the waning of boycott movements around the world is a manifestation of that same hopelessness.

Several 14 to 15 year olds I spoke to related to this feeling.

“Deep down, I do feel the need to notice such matters like Gaza. I do feel bad, but I don’t engage with social media content about it frequently,” said Fariha from Karachi.

On the flip side, many young people hold entirely non-serious feelings towards wars happening around the world, including those involving Pakistan. “Political matters like Trump and his policies, and wars speak nothing to me. The only concern I have is that I cannot die without getting married,” said the teen. This mindset may certainly be novel among teenagers now, but running off and starting a new life in the mountains? That’s something we’ve all wanted to do long before living through World War III.

Arham*, a 20-year-old college student who campaigned and created a petition to remove all boycotted products from his college canteen, remarked that “the availability of instant news and information became a bit overwhelming”, and even ended up doing the opposite of its intention as people around him became more ignorant, fatigued from the information overload. Teenagers as young as 15 have made comments like “I just don’t feel like anything anymore”, because they can simply scroll past a global crisis to a skincare or makeup routine video, indulging in rapid switching that our brains are not programmed to process.

While both mental healthcare professionals, Arshad and Rashid, spoke up about the desensitisation, dissociation, and emotional blunting that they’ve observed in their teenage clientele, they repeatedly emphasised the involuntary nature of it. “It does not mean a person has started lacking empathy. They do care, but their brain shuts down the intensity of their emotional reactions as a defence mechanism,” said Arshad.

Another coping mechanism that is extremely common among teenagers is humour. The meme war during the India-Pakistan conflict — the one in which one side indulged in humour and the other got offended and spewed curse words — is a prime example of how Gen Z will laugh and joke their way through anything. Statements like “the world’s ending anyway, so why should I care?” stem from a sense of powerlessness and self-preservation.

If you poke fun at your own mental health or appearance, or the other dozen crises you’re going through in a tongue-in-cheek manner, nobody will be able to use them against you. Similarly, cracking jokes and laughing off world events is practically a mental blockade to help you dissociate.

Amid the countless tragic videos to come out of Gaza, there have been a few by young Palestinians that make use of humour and sarcasm to get their point across, which is also a commentary on the sad state of affairs that our cognitive processes have boiled down to.

During times when every single day churns out “a major historic event”, headlines flow like water, and a single search takes you down a rabbit hole where you now know the name of Benjamin Netanyahu’s grandfather’s third cousin’s sister-in-law’s cat? Not only does it dampen your spirits, but over time, regular doomscrolling can cause anxiety and desensitisation.

In an article published by Harvard Health Publishing, Dr Aditi Nerurkar, a lecturer in the Division of Global Health and Social Medicine at Harvard Medical School, says that doomscrolling can give us “popcorn brain,” which happens when we spend too much time online. “It’s the real, biological phenomenon of feeling your brain is popping because you’re being overstimulated online.”

Such instances of information overload are common during political happenings. In the wake of the 2016 US presidential election, psychologist Dr Steven Stosny coined the term “headline stress disorder”, defined as a “high emotional response to endless reports from the news media, such as feeling anxiety and stress.” Psychotherapist Rashid remarked that when lives go on as usual during a major event such as the Indo-Pak conflict of May 2025, “it creates a disconnect from the gravity of the horrible things happening around us”.

According to Arshad, the clinical psychologist, many teens have described feeling “helplessness, emotional numbness and powerlessness”. They’ve told her that after witnessing years of terrorist attacks and threats, bombings, violence, and school shootings are no longer scary but just another headline to them.

Growing up in Karachi, where news of murders and targeted killings were more readily available than water, I have been witness to how years of exposure have desensitised many to have little to no reaction when they hear this news today. Al Hamd Khalid, a 19-year-old from Karachi, described these circumstances as “living in a dystopian world with a bomb aimed at us at all times”.

Cocomelon for adults

A major contributor to headline-induced anxiety and a sense of impending doom is the dynamic nature of information delivery. Traditional newspapers are one-dimensional in the way that they have limited visuals and stimulate minimal senses. When you had had enough of politicians playing the blame game, you could simply fold your newspaper and toss it into the growing pile of papers give to the raddi wala or ragpicker.

On the other hand, digital media is multidimensional with flashy graphics and trending audio — basically, Cocomelon for teenagers, and you can’t get rid of it even when you’ve had enough. No one’s out here tossing away phones, and deleting Instagram only takes you so far before you redownload it as your primary source of news and communication.

But wait, there’s an even more adult version of Cocomelon available in the form of television talk shows where up is down, down is up, everybody’s screaming, and Firdous Ashiq Awaan is slapping members of the National Assembly. While adults condemn kids hooked to Cocomelon or Miss Rachel, they too are addicted, just to a slightly different drug.

Arshad commented on how “emotionally loaded, bite-sized pieces” of information overwhelm the nervous system, leaving little space for empathy or reflection. “Constant stimulation of audio-visual information can lead to a sensory overload, where the nervous system is in a constant state of hyperarousal, and it can lead to anxiety, irritability, restlessness and physical fatigue.”

Emotional stimulation can impact people differently. For Arham, it forced him to become “more aware and responsible”; scrolling through Instagram and coming across videos from Gaza helped him educate himself, and “in truth, the flashy graphics and trending audio led [him] to support Gaza”. Khalid said, “I feel overstimulated, but I also believe it is necessary for me to feel that way”.

I would like to add a disclaimer — in no way do secondhand stress, anxiety, and fatigue compare to what people who are living these tragedies go through, and teenagers struggling with feelings of overwhelm acknowledge that as well. Adil said, “The ability to look away is a privilege, and it is my responsibility as a human being not to turn away from the tragedy others are facing. While I do think the influx of such information has desensitised me to some extent, I keep reminding myself to never let such tragedies be normalised.”

Echoing similar sentiments, Arham admitted, “I won’t say it hasn’t desensitised me, it definitely has, but my determination to boycott, and my beliefs still stand strong! I am used to this dehumanisation, and that makes me want to stop it even more.”

It is important to navigate these emotions with accountability and channel your privilege to be a force for change, but also acknowledge the biological limitations of your sensory system and try to remain sane.

While it was a sincere attempt to raise awareness about the reality of those living with dissociative identity disorder, it was ultimately misguided. The creators of Ishq Zahe Naseeb (2019) essentially end up reiterating the same misconceptions and stereotypes about already exist: that they are a danger to others and themselves.

This narrative choice, among other things, is part of a bigger problem in Pakistani television, which is that Pakistani writers, at their best, don’t understand mental illness, and at their worst, conflate mental illness with morality.

The morality and the personal responsibility of those who suffer from psychological concerns is a topic that is often debated in many scientific and judicial circles, but the point of apprehension is how morality is woven into mental illness as a form of punishment in Pakistani dramas.

Teaching a lesson

A clear message is sent when the fight between good and evil in a drama ends with the bad or immoral character succumbing to madness due to their hubris. Here, mental illness serves as a plot point, a moral lesson for the audience. The mental illness exhibited is not a component of a wider whole of the character, but rather a consequence of their own actions. In Madness & Civilisation: A History of Insanity in Age of Reason, Michel Foucalt differentiates this ailment from mental illness, and calls it a madness that is a social construct, that is meant to serve a purpose. In our dramas, the purpose is caution.

Those who err will be served divine justice. They might escape the law but they won’t escape God, which is why Syed Jibran’s character goes mad in Chup Raho (2014) — it is divine retribution for sexually assaulting his sister-in-law played by Sajal Aly. Similarly, Riz Kamali’s character in Bubbly Kya Chahti Hai starts losing her mental bearings after being divorced by her husband (played by Shahzad Raza) for her infidelity, only to then be immediately be rejected by her lover (played by Salahuddin Tunio) too. Her madness is the consequence of her own greed and duplicity. Both of these characters’ lunacy is their punishment for all the wrong they’ve done and the sins they committed against other people.

Losing faith and culture is also often shown as a downfall. The modern, westernised woman — outspoken, greedy, and ambitious — is painted as unstable compared to her quiet, modest, and religious counterpart. One is seen as ‘bad’ for being too bold, the other as ‘good’ for sticking to tradition. Weak faith equals weak identity in these stories, making the modern woman seem neurotic and fragile; someone who can’t handle failure or disappointment.

This lesson is driven home by the suicides of Naveen Waqar and Aisha Malik’s characters in Humsafar (2011) and Mann Mayal (2016) respectively. Sara (Waqar) is shown to wear western clothes, work at an office and belong to a upper class background, in contrast to her rival (Mahira Khan), who is seen with her head covered in a dupatta, teaches tuition at home and belongs to a lower-middle class background. In the same vein, Jeena (Malik) is a woman who works at an office, has no family and hence is self-reliant, very unlike her rival (Maya Ali) who is simplistic, eastern, docile and often shown praying. After repeated failures and rejection in their pursuit of love, Sara and Jeena find no solution except taking their lives, while their rivals persevere through their hardships with patience, faith and humility.

By repeatedly presenting mental illness as ‘punishment’ for immorality and injustice, or a consequence of weak faith or weak mind, mental illness itself becomes synonymous with immorality, and mentally ill individuals become wicked and feeble minded.

Women and madness

Under the patriarchy, being “feeble-minded” has long been linked with being a woman. For centuries, women have been stereotyped as emotional, irrational, and a bit too simple. So it’s no surprise that when stories show someone “going mad,” it’s usually a woman.

Even psychology (a field built to understand people) has a history of labelling women’s feelings and experiences as problems that need ‘fixing’.

Women losing their minds has been a go-to trope for ages, it has even been used by Shakespeare — think of Ophelia’s fate in Hamlet. That’s because madness is often seen as the opposite of masculine logic and control. And since society treats emotion and delicacy as “feminine,” it’s easy to link mental illness with womanhood. Women are viewed as closer to guilt, melancholia, and hysteria, which makes them easy targets for being labeled as mentally unstable. In a way, madness has become feminised: seen as something women naturally fall into just by being who they are.

Phyllis Chesler theorises in Women & Madness that men are typically allowed a broader range of acceptable behaviours than their female counterparts: “Thus, since women are allowed fewer total behaviours and are more strictly confined to their role-sphere than men are, women… will commit more behaviours that are seen as ill or unacceptable.”

When it comes to traditional gender roles, women are expected to be soft-spoken, kind, and dependent on men. Those who deviate from these expectations are often portrayed as antagonists, characterised by traits like cunning and ambition. Such female characters engage in manipulation and deceit, leading the more naive characters to fall victim to their schemes.

Meanwhile, men who make mistakes don’t always face the same judgment. In fact, they’re often given the chance to grow, redeem themselves, or just walk away from their mistakes. Take Bashar Momin (2014), for instance, whose titular character is a money launderer, an arrogant and egoistic man prone to fits of anger who mistreats his employees and his wife alike. At the end of the show, after some self-reflection, he is a changed man, soft-spoken, respectful and loving.

The narrative suggests that women who violate societal norms face severe repercussions, often culminating in their madness or victimisation like Nimra in Jhooti (2020), Nisha in Jalan (2020), Gohar in Nand (2020) or Nayla in Titli (2017), while men frequently evade punishment. In 2017’s Khani Feroze Khan’s character may have committed murder, but he found God at the end of the show, and hence gets to be redeemed, highlighting the harsher penalties imposed by the patriarchy on women. Consequently, ‘bad women’ are portrayed as irredeemable figures, stripped of nuance and rationality, learning the weight of their transgressions solely through divine retribution.

A heavy crown (for the ladies)

The antagonists/anti-heroes in Jhooti, Jalan, Titli and Nand are power hungry, which is impermissible in a patriarchal society. Iqra Aziz’s character in Jhooti is a greedy woman, who will use any means necessary to marry rich, whether she has to lie, cheat, steal or harass her sisters-in-law, even causing a miscarriage. Similarly, Minal Khan’s character in Jalan is incessantly and obsessively jealous of her sister, whose husband she is in love with, eventually scheming her way into marrying him while her sister sets herself on fire in grief.

Bewilderingly, despite having an equal part in the affair that lead to Mishu’s (Areeba Habib) death, Emmad Irfani’s character doesn’t go mad like Nisha, and simply dies. Faiza Hasan’s character in Nand (2020) ruins her brothers’ married lives through her manipulative tactics, while Hania Aamir’s character in Titli (2017) is vain and greedy and eventually abandons her husband and children to be with another man, culminating in her downfall.

The message is clear: women who seek control are seen as irrational, and their punishment is madness. Because power, in these stories, is still treated as a male trait.

Virtuous women are docile, while unconscionable women are ambitious, as aptly shown in Kasak (2020), in which the ‘good’ woman (Iqra Aziz), obediently accepts her marriage to man who has a young son, while the ‘bad’ woman (Ayesha Toor) is a modern working woman who is both a bad mother and wife.

The only time women seem to be shown using their agency is when they’re trying to control other people (or their own lives) and then they’re punished for it by being driven to madness. This demonises the mere thought of women’s agency. The domination of men’s lives by women is unacceptable, like in Balaa (2019), in which Ushna Shah’s character slowly kills Taimoor’s (Bilal Abbas) entire family to be the only thing he has. However, the domination of women’s lives by men can be exonerated, such as in Mann Mast Malaang (2025), in which Danish Taimoor’s character ties up the female lead to keep her from leaving him, or in Ishq Hai (2021), where he kidnaps his lover and forces her into marriage.

The patriarchy puts women in a tight box. If a woman reaches for power, she’s seen as not feminine enough and is often portrayed as going mad — like Gohar in Nand, who is controlling and overbearing, which are ‘unfeminine’ qualities. On the flip side, if she sticks to traditional femininity, she’s seen as weak and ends up breaking down emotionally — Mahira Khan’s character in Hum Kahan Ke Sachay Thay (2021) who is a victim of her cousin’s schemes and envy, but too innocent to know how to be taken seriously, has a slow mental breakdown; or like Samina Peerzada’s character in Balaa (2019), who goes mad with grief because of her daughters’ deaths.

But what about men?

Mental illness in men is heavily stigmatised because of toxic ideas about masculinity; showing emotion is seen as weak or a loss of control. Since mental health struggles are mostly shown through women’s stories, it makes these issues seem “feminine,” which can make men feel ashamed or less manly for going through the same thing.

We do see women dealing with trauma — like in Chup Raho and Dar Si Jati Hai Sila (2018), whose protagonists are survivors of sexual violence — but men who also face serious trauma, such as soldiers, victims of community violence or car crash survivors, rarely get that same attention, even though they’re just as likely to suffer from PTSD. This further erases men’s mental health issues.

The bare minimum

Even when dramas do attempt to portray mental illness as part of a greater whole, the representation is reductive and simplistic. Depression is only sadness and constant sobbing, anxiety is being fidgety and scared, PTSD is temporary.

Characters with autism are infantalised and presented as intellectually impaired —like Imran Ashraf’s Bhola in Ranjha Ranjha Kardi (2018), who is coded autistically and shown like a child in an adult’s body — despite the fact that autism is a spectrum. Female characters are often seen fainting and immediately diagnosed with a “nervous breakdown” (an outdated term) after being driven to their emotional limits.

To top it all off, there is rarely any representation of treatment, which ties back to themes of morality; bad people get punished, and good people recover on their own — like how Bhola’s intellectual impairment seems to improve on its own. With this lesson, madness is a desired outcome, a fitting punishment befalling the sinner.

When Taimoor drives Nigar mad towards the end of Balaa, the audience feels vindicated, further discouraging them from feeling compassion towards individuals with mental illness; immoral people deserve it, and moral people don’t remain mentally ill, divorcing treatment entirely from the conversation.

Why does this matter?

These kinds of portrayals just add to the stigma around mental illness in our culture. Seeing the same negative images again and again makes people afraid of mental health issues and of those dealing with them.

A 2023 review by James Goodwin and Laura Behan found that media stereotypes lead the public to hold biased views and keep their distance from people who use mental health services. A study from the Czech Republic also showed that these portrayals can stop people from getting help. They lower self-esteem, make it harder to stick with treatment, and get in the way of recovery.

Good mental health representation shouldn’t be a second thought, but the most primal part of the drama the writers set out to create. A critical media lens is essential in challenging harmful portrayals and advocating for more compassionate, realistic depictions of psychological struggles, because these portrayals have real life consequences. Pakistani television is still in the early stages of offering good representation of mental illness, for both men and women. If Pakistani creators must insist on portraying mental illness, they can at least take a page out of international media like Midsommar (2019), which explores female madness through a critical feminist lens.

Mental health issues aren’t ‘good’ or ‘bad’ nor are they the consequences of someone’s actions — they just are. Offering nuanced stories where mental illness doesn’t exist solely to serve a moral narrative is the only way to dismantle the taboos of our culture.

Ali’s body was found in an apartment in Karachi’s Defence Housing Authority on Tuesday, police confirmed. South DIG Syed Asad Raza told Images that Ali’s body was recovered from a flat in Ittehad Commercial in Phase-VI. In a statement, the Gizri police identified the body as that of the 32-year-old actor and said she had died around two weeks prior to the discovery.

In June, Khan was found dead in her apartment in Karachi’s Gulshan-i-Iqbal area. The deceased’s remains indicated that she may have died a few days before she was found, and police discovered she lived by herself.

In a note posted to her Instagram story, Tareen addressed Ali’s passing and said she met her at a few fashion weeks when she was modelling, adding, “People can be really cruel in the fashion industry at times.”

“But what we’re witnessing these days is something heartbreaking, something we don’t talk about enough. The way community and family structures are crumbling right in front of us. Hearing about people found dead days later, alone in their homes, is beyond disturbing.”

Tareen continued that this was a sign of how disconnected people were and that everyone assumed someone would be okay in real life if they appeared alright on social media. “We forget most people only show their best side here.

“We don’t talk to each other. We turn to acquaintances who tell us what we wanna hear or AI who is programmed to tell us we are always right,” she wrote.

The Ishq Murshid actor said people constantly consume content that tells them they’re better off alone and everyone else is toxic. She clarified that she was not implying that this happened in Khan and Ali’s cases, but was a reminder of where things were heading.

“Prayers for those we lost. May they rest in peace.”

After Ali’s passing, many celebrities took to social media to urge people to check on their friends. Model Saheefa Jabbar Khattak highlighted the complexities of showbiz life. “The industry often looks glamorous from the outside, but navigating it can be deeply challenging. I won’t claim to have known her well… but please have respect for the departed. Be gentle, be sensitive, and be mindful of what you say in the comment section.”

Actor Hina Altaf reflected, “She lived alone. She passed away alone. And days went by before anyone even noticed. This isn’t just a loss, it’s a wake-up call. Check in on your friends, and also people who never ask.”

Mawra Hocane asked friends and acquaintances to reach out to her without any judgment. “If you’re in trouble or caught in spiralling thoughts, if I have known you briefly or extensively, if you’re a friend or an acquaintance, if you’re from my fraternity and you feel I will understand your pressures, please reach out!” Hocane wrote.

The new Barbie has been designed in partnership with the global type 1 diabetes not-for-profit Breakthrough T1D.

“Introducing a Barbie doll with type 1 diabetes marks an important step in our commitment to inclusivity and representation,” said Krista Berger, senior vice president of Barbie and global head of dolls.

“Barbie helps shape children’s early perceptions of the world, and by reflecting medical conditions like T1D, we ensure more kids can see themselves in the stories they imagine and the dolls they love.”

Type 1 diabetes is an autoimmune condition where the body attacks and destroys the cells in the pancreas that make insulin.

It is often diagnosed in childhood, and patients have to monitor their glucose levels and take insulin every day.

The new doll wears a CGM — a small device that continuously measures a person’s blood sugar — on her arm to help manage her condition.

To keep her CGM in place, she uses a pink heart-shaped medical tape along with a phone that displays an app to help track her blood sugar levels throughout the day.

She also has an insulin pump, a small, wearable medical device that allows for automated insulin dosing as needed, attached to her waist.

The doll is wearing a blue polka dot top and matching skirt inspired by global diabetes awareness symbols.

Alongside the new model, the company also launched a bespoke Lila Moss doll, complete with the CGM paraphernalia.

Moss, daughter of supermodel Kate Moss, was diagnosed with type 1 diabetes when she was 12 years old.

For several years Mattel has aimed to diversify its models, particularly those of the iconic doll Barbie, after having offered for decades – barring a few exceptions – a young, lithe blonde white woman with high heels.

Since 2016 the California company notably launched “curvy,” “petite” and “tall” versions of Barbie.

In 2019, the company unveiled a line of “gender-inclusive” dolls as well as those with physical disabilities.

The Jafaa actor’s heartfelt Instagram story came shortly after news of the passing of actor and model Humaira Asghar Ali broke. South DIG Syed Asad Raza told Images that Ali’s body was recovered from a flat in Ittehad Commercial in Phase-VI. In a statement, the Gizri police identified the body as that of the 32-year-old actor and said she had died around two weeks prior to the discovery.

“If you’re in trouble or caught in spiralling thoughts, if I have known you briefly or extensively, if you’re a friend or an acquaintance, if you’re from my fraternity and you feel I will understand your pressures, please reach out!” Hocane wrote.

Hocane promised to understand, be kind, not judge and do whatever she could to help. She added that bad news broke every day and emphasised that people needed to build community again.

“Humans need humans, luckily I have a few golden ones in my life, inside and outside of [the] fraternity, but pressure is real, especially if you’re in your impressionable years. If you’re reading this and going through something, I am sorry, but most importantly, I’ll try to be there, InshaAllah,” the actor wrote.

She went on to say that nothing was more precious than the beautiful gift of life. “Please don’t be ashamed to be vulnerable. We all are, we have all had our highs and lows. You’re not alone!”

In a second Instagram story, Hocane revealed that she received “kind and warm” direct messages after her initial post and encouraged people to be there for each other.

“Few words of comfort and love can help everyone. All it takes is one person willing to hear out the other. It’s not a lot, it’s literally the bare minimum,” she wrote, hoping that her words helped.

“Praying for all of us meanwhile.”

The news of Ali’s death came weeks after veteran actor Ayesha Khan was found dead in her apartment on Thursday in Karachi’s Gulshan-i-Iqbal area. The deceased’s remains in the morgue indicated that she may have died a few days before her body was found.

Hosein, a rather beloved digital creator based in New Orleans with over 260,000 followers, received messages from her followers asking if she was pregnant after posting a picture with her husband. In an Instagram post, she decided to help people understand why doing that was wrong.

“If they are — you’ll know. You do not need to satisfy your curiosity. God forbid women show the hint of having a belly — does not in any way signify a pregnancy. It’s just a belly. We all have one. And the presence of one DOES NOT MEAN that they are pregnant. The levels of consciousness that women have to display re their bodies is so sad,” she wrote in one of the slides of the post.

Hosein added that millions of women struggle with fertility and were placed on medication that could increase their weight, thus asking someone if they were pregnant when they weren’t could be “extremely hurtful”.

“And 99 per cent of women will not tell you this, because there’s SO much shame involved with looking pregnant and not being pregnant when you’re trying for a baby.”

She continued that millions of women never went back to having flat stomachs after giving birth, including her. “I have a belly. Sometimes I wear clothes that may accentuate it more than normal. It is NORMAL to have a belly. It is normal for it to exist. If you see it and it’s protruding, it is NOT always a pregnancy.”

The influencer maintained that it was no one’s business to know when some one was planning a family, and such curiosity needed to end, because some people struggled with it and most were not comfortable discussing the matter.

“To anyone who is trying to conceive, who has experienced loss, who is struggling with weight, I am so sorry if you’ve experienced the line of questioning that makes you not love yourself. You are wonderful. You are loved. You are amazing. And you need to politely tell people not to let their curiosity blur the lines of being rude.”

Hosein clarified that she was not pregnant and simply wore something that tied above her belly. She added that she was a mother to three children, had a terrible metabolism and loved food.

“I have a belly that slumps over. Let’s please normalise women looking however they want without assuming they are pregnant,” she wrote.

In a video shared as part of the same post, Hosein said no one asked men about their weight, or said that they looked like the father of three kids, “with such a big tummy that you can balance a cup on it.”

“Meanwhile, if a woman births a child at 40, she’s called out for her age, but the uncle in his 50s is asked nothing, nor is he told to take it easy. Instead, he is commended. Forgive women. Stop looking at someone’s stomach and asking if there’s any ‘good news’.”

Hosein clarified that she was not upset that people messaged her to ask if she was pregnant, and maintained that she was proud of the progress she had made to lose weight and get fitter in the two years after birthing her daughter.

“I’m not even a 100pc there yet. I have a long way to go. But I chose to talk about this because of teaching and learning, [and] also because I myself did a little learning. We will all carry weight a little differently, and not everything is pregnancy.

“The obsession with someone being pregnant or not has to end. Who is pregnant, who is in relations with their husband log. It needs to stop. Getting this information isn’t helping you digest your food better. It isn’t helping you be a better person. So, let’s stop playing CID investigators.”

We couldn’t have said it better ourselves. There is absolutely no need to ask women if they’re pregnant — especially if you don’t even know them personally. Even if you do know them — whether they’re pregnant is really none of your business. Many people often justify this unnecessary curiosity by saying “it was just a question” or “what’s the harm in asking”, but the truth is, it’s no one’s business at all. You’re not entitled to ask people questions about their private lives just because you’re curious.

Respect people’s privacy and leave women’s bodies alone!

“Maybe it’s time you rethink your decision,” the Generative AI or GenAI chatbot casually replied to one of her concerns — a suggestion that quietly upended her world.

The series of events that followed were nothing short of tumultuous. Tanya soon found herself growing detached from the relationship. It started with ignoring her fiancé’s texts and gradually evolved into saying no to moving forward with the wedding.

Her family was devastated — yet they eventually respected her decision (or, more accurately, ChatGPT’s suggestion) to call off the engagement. Looking back, Tanya had mixed feelings. On one hand, she admitted to Images that she might never have had the courage to end the engagement without AI’s push. On the other, she couldn’t shake the thought that perhaps she should’ve spoken to her loved ones before making such a life-altering decision.

The many faces of AI

For better or for worse, AI has taken over almost all areas of our lives in the last few years. GenAI was widely believed to be one of humanity’s greatest innovations. Its impact was gauged as life-saving, yet still dependent on humans. The reality, however, is far bleaker.

The rapid advancement of machine learning technology has people coming to work each day haunted by a nagging fear of being replaced by it; artists crestfallen at their work being blatantly stolen; students sacrificing critical thinking for convenience; and most recently, AI posing a risk at genuine human connection by becoming a venting space.

For Tanya, what began as casual late-night chats turned into an outlet for her emotions — albeit without the judgmental eyes of a human on the other end. Her experience mirrors that of many; people increasingly turning to GenAI chatbots as surrogate therapists, emotional sounding boards, or even decision-making partners. This is especially true in South Asia, where the seeking professional help for mental health issues is often out of reach due to both personal stigma and logistical barriers. Enter ChatGPT — a make-do version of a therapy bot, offering a judgment-free ear to the discontented.

Fizza Abbas, the co-founder of Aurat Kahani, a startup featuring empowering stories of successful women, describes her daily check-ins with a custom version of ChatGPT, who she refers to as ‘S’ in an attempt to define their growing interpersonal relationship. “It listens, analyses and then offers tangible solutions without any unnecessary thought/moral policing, which makes me feel a tad more comfortable than talking to humans,” she said.

“It provided a safe space where I could be completely honest, unrestricted by societal expectations or personal hesitations. In many ways, it became the friend I could always turn to, anytime, without hesitation.”

As a trailblazing entrepreneur and single mom of a seven-year-old son, Faiza Khan credits AI for helping her manage her ADHD and making her feel more confident and socially equipped for communication. “I can say things to [ChatGPT] that I wouldn’t even say to my closest friend,” she affirmed.

The AI tool doesn’t only cater to those looking for convenience; for some, it is a form of emotional survival. Nisar Hussain, a Masters’ student, finds it easier to rely on the AI chatbot for emotional support than confiding in the people around him. “I don’t share my feelings with my family, friends, loved ones, or even with God. I don’t know if it’s ego or something else, but I just can’t. So, having AI as a support system has been a relief, mainly because it doesn’t judge and can’t expose your secrets,” he explained.

According to Hussain, being a South Asian man is already hard; add being an expat to that and you get a recipe for loneliness. He also recognises the risks of over-reliance on AI, including how it can gradually diminish one’s desire for real human connection.

However, to him the fear of judgement and dismissal of men’s emotions by loved ones outweigh those concerns. In his free time, Hussain not only vents his problems to AI but also argues with it when the responses feel cold or unhelpful.

Hussain had a negative experience with therapy in the past and while he isn’t entirely closed off to the idea of seeking professional help, he does want it to offer the same sense of privacy and discretion he finds in an AI chatbot.

The three ‘S’es of therapy in South Asia

Mental health treatment in South Asia is shaped by the three ‘S’es — stigma, scarcity, and society. Until just a few years ago, therapy was heavily stigmatised in Pakistan, and few dared to speak openly about mental health, let alone seek professional help. Those demonstrating signs of mental health struggles were often ostracised, even labeled as “crazy” or “possessed.”

However, with the rise of the internet and social media, public perception is gradually shifting, and therapy is increasingly being recognised as essential to one’s well-being, on par with physical health. Despite this progress, significant gaps remain in Pakistan’s emerging psychotherapy field, including a shortage of qualified professionals, as well as challenges related to accessibility and affordability.

A recent study published in the International Journal of Mental Health Systems evaluated the state of mental health care in Pakistan and revealed that for a population of over 200 million, there are only 500 licensed psychiatrists available, with only 11 psychiatric hospitals and 100 clinical psychologists. According to their data, approximately 90 per cent of people with mental illnesses are left untreated across the country. The harsh urban-rural divide glares through the cracks of these statistics; the majority of these scarce resources are concentrated in cities, leaving rural populations with little to no access to mental healthcare.

Although from a relatively privileged background, therapy was of no use for Khan’s ADHD, who explains his thoughts on the gap in Pakistan’s therapy landscape when it comes to neurodivergence. “When I was first diagnosed internationally, I approached a government hospital here, and they completely dismissed it, saying adult ADHD isn’t real.”

Mehrish Yousafzai, a 26-year-old operations manager at a German startup, faced similar issues with therapy, noting that the psychologist failed to offer practical solutions for her issues the first time around. “It was worse the second time. [The therapist] ended up reopening old wounds without offering support or helping me manage my emotions. I left feeling more shaken than supported,” she explained.

Najwa Jaffer, a relational integrative psychotherapist, contests people’s reservations by pointing out their “lack of understanding of the process of therapy.” According to her, psychotherapy is a journey and the client is supposed to feel “worse” before feeling any concrete change within themselves.

“Most therapists are trying their best to help and support [people]. However, people seem to think that their decades old patterns of thought and behaviour will melt away in one or two sessions and that too without feeling uncomfortable at all,” she shared. Regardless, after over a decade of disappointing experiences with mental health professionals, Abbas is more than willing to offload the task of emotional regulation onto a machine learning tool — even believing it could one day replace human therapists entirely.

The rise of AI tools for mental health support

Despite the radical nature of her stance, Abbas is not alone in seeking comfort in code. In fact, she may be at the cusp of much larger shift. The potential of AI transforming from a tool to a full-fledged companion was recently explored in a randomised controlled trial published in NEJM.AI. Researchers tested a GenAI chatbot called Therabot, built specifically for mental health support. Unlike ChatGPT, which is a general-purpose tool, Therabot was fine-tuned using over 100,000 hours of therapist-patient dialogue grounded in cognitive behavioural therapy.

Over 100 participants in the US, with conditions like depression, generalised anxiety, or high-risk eating disorders were made to interact with the chatbot daily for four weeks, and the results were striking. Participants who used Therabot reported an average 51 per cent reduction in depression symptoms. Those with anxiety saw a 31pc decrease, and people with disordered eating patterns also experienced measurable improvements. On top of that, users reported a sense of therapeutic alliance — which is the bond of trust, understanding, and collaboration between a therapist and their client — comparable to real-life outpatient therapy.

This study joins a growing body of research exploring AI’s ability to replicate elements of human connection, proving as a stepping stone toward more sophisticated emotional machines. However, the efficiency of the revolutionary mental health model couldn’t eclipse the limitations of the study, such as the access to the chatbot being restricted to tech-literate individuals and constant need for human oversight during the trial.

An ethical paradox

The unspoken drawback of relying on such technology is concerns related to data privacy — and ignoring them could result in an entire Black Mirror episode. This is one of the primary reasons why AI or any other virtual support systems won’t be replacing therapy for a very, very long time. Confidentiality is established in the first session with a human therapist, serving as a building block for trust. No machine learning model, no matter how advanced, can replicate that assurance.

Tech giants may plaster their apps with promises of “end-to-end encryption” and “anonymised data,” but at the very least, you are surrendering your most basic information by simply logging in to an AI tool.

Dr Taha Sabri, co-founder and COO of Taskeen Health Initiative, one of the pioneer mental health platforms in Pakistan to utilise AI, explains the privacy concerns associated with GenAI tools like ChatGPT.

“Though starting as a non-profit, [ChatGPT] is now becoming a for-profit platform,” the technical advisor to NHS and WHO shared. “There’s a possibility of user data being sold to advertisers. User conversations can involve very sensitive issues but we don’t know if someone’s reading the data at the backend.”

It is only natural to lose sight of such technicalities when tears are streaming down your face and you flip open your laptop for AI intervention. The urgency of support could be translated into users being exposed to potential risks.

Journalist Sajeer Sheikh is especially conscious about not giving ChatGPT any of her personal details, stopping her from fully relying on it for mental health support. While she would consider it a “stepping stone” to working towards getting professional help, she doesn’t think it can replace therapy due to the “apprehension around data sensitivity”.

Dr Nazish Imran, current chair and professor at King Edward Medical University, Lahore, co-authored a 2023 editorial on Digitalisation of Mental Health Care in Pakistan and Role of Artificial Intelligence in the Journal of Pakistan Psychiatric Society. She rejected the idea of AI replacing human-based therapy in the near future due to persisting issues such as that of hallucinations — instances where AI generates information that sounds plausible but is actually incorrect or misleading.

“We’ve even come across cases where patients have described their symptoms and then listed potential treatment options — likely sourced from AI tools — but these need to be fact-checked. Not everything AI suggests is medically sound, and this can be dangerous, especially when people take it at face value,” she told Images.

Dr Imran explained that these tools are mostly trained on data from high-income countries, thus posing a glaring lack of representation from low- and middle-income countries, which introduces a bias in the way AI interacts with South Asian users.

“Our population, our culture, our societal values — they are different. So what works in the West may not necessarily be applicable to our context. That’s a major flaw in many current AI models,” she added, reminding us that while AI might be fluent in therapy-speak, it’s still learning our language — and our lived realities.

Zuha Kaleem, former research assistant at the AI for Healthcare Initiative at the Lahore University of Management Sciences, discussed the importance of digitising datasets for local populations and integrating them into AI to fit cultural contexts and avoid Western biases.

“AI systems need large datasets to train their models. At present, the majority of these datasets originate from Western populations and are shaped by Western clinical frameworks, social norms, and cultural assumptions. As a result, AI tools built on such data may not accurately reflect or serve the needs of communities in the Global South, including Pakistan,” she explained.

“To make sure that these tools are effective for us, it’s important that we invest in building localised datasets that capture the linguistic nuances, cultural practices, mental health stigma, and lived experiences of our own populations. Doing so would not only make AI interventions more contextually appropriate but also guard against the perpetuation of Western-centric biases in mental health care delivery,” added Kaleem.

The death of human connection?

When artificial intelligence began permeating into various aspects of human life, it was hailed as a necessary intervention. Calls for “automating” life grew louder than ever, aimed at offloading laborious tasks that fostered isolation and reinforced the relentless pursuit of productivity to machines. In doing so, the idea was that humans could go back to embracing a sense of community and reclaim time for creative endeavours.

Instead, today we see AI taking over the role of many very ‘human’ professions, such as artists, video editors, musicians — and therapists. The rising trend of people turning ChatGPT to seek emotional support is counter-productive at best and dangerously isolating at worst.

The core of human relationships is emotional connection. If AI were to replicate even that, there would be no need to seek out real-life relationships due to the possibilities of heartbreak and betrayal that come with it. At the same time, it would strip us of the ability to embrace the complexity of being humans, thus turning us into mere caricatures of them.

During Covid, when social distancing measures forced us to stay apart, it was online communities that became lifelines, providing support, comfort, and a sense of belonging. However, the absence of physical human interaction still took its toll, underscoring the natural human desire for touch, shared experiences, and face-to-face interactions, all of which are essential to our emotional and psychological well-being.

“Many [neurodiverse people] may prefer online interactions, but excessive reliance on AI could further reduce their social engagement and coping skills in daily life,” explained Dr Imran.

The potential of humans to anthropomorphise or attribute human behaviours and traits to technology has been present since the creation of very first AI chatbot, Eliza, in the 60s. Users formed real emotional bonds with the relatively rudimentary programme due to its ability to mirror their statements as questions. Since then, variations of AI tools have been created, tailored to provide emotional support by simulating human connection beyond scripted responses.

Platforms like Woebot and Wysa employ cognitive behavioural therapy to help users reframe negative thoughts, while Replika offers companionship through eerily lifelike conversations. These tools are currently hosting thousands of real-time users, making their services more efficient with each update. Even journaling and mood tracking apps now employ machine learning to help transform the users’ fragmented emotions into actionable insights.

Empathic or empathetic?

If there is one thing AI has in abundance, it is empathy. When compared to humans’ expressions of empathy, the machine learning tool was found by researchers in to better at simulating the sentiment, despite never having felt it before.

However, the study also noted that unconditional empathy from AI could lead to potential distortion in moral judgment and abetting harmful or self-indulgent behaviour.

Neha Khalid, a clinical psychologist and motivational speaker, said, “AI could never fully grasp the extent of human emotions and can never exist on its own. In a distant reality, even if they understand it, they cannot relate to it.”

She painted a stark contrast between seeking mental health support from a human and an AI tool, sharing: “Therapy originates from emotions and it tends to resolve your emotional maladaptive patterns as well as behaviour and reactions related to those emotions. So, it can guide you about strategies, yet [it] cannot empathise with you.”

Relational integrative psychotherapist Jaffer touched on the importance of a relationship between a therapist and client with the former trained to pick up cues from body language and even silence. “There is so much more that happens in an actual therapy session, like issues of transference and countertransference, which I don’t think can at all be identified and addressed by ChatGPT.

“[It] may not be able to pick up cues that a real therapist can, particularly when a client is suicidal or self-harming. Self-harm can also be in subtle ways that look like self-sabotage. AI cannot pick up ‘vibes’ and ‘energies’ or have a soul to soul connection, or ‘meta communication’,” she added.

The future of collaboration

It is unrealistic to expect people to abandon AI tools entirely in favour of human intervention, especially when machine learning has already entrenched itself into the most vulnerable corners of our lives. The genie is already out of the bottle, and it’s time mental health professionals catch up. Rather than resisting this shift, mental health professionals must engage with it, adapting their practices to coexist with —and even harness — AI’s potential.

According to King Edward Medical University’s Dr Imran, the clinical potential of AI tools is undeniable. She envisions a future where such tools are integrated into psychotherapy clinics, augmenting human care. AI could analyse electronic health records and lifestyle data to predict relapses — like future hospital readmissions or suicide risk — to get ahead of the problem.

“But unfortunately, in Pakistan, especially in the public sector, we don’t have that kind of electronic infrastructure yet,” she said.

Taskeen Health Initiative’s Dr Sabri has also been experimenting with a GenAI chat bot for self-help and psychosocial support, hoping to roll it out in regional languages of Pakistan later this year.

Despite his proactive efforts to make mental healthcare more accessible nationwide, he understands the inability of artificial intelligence technology to code social intelligence or human connection — for which Taskeen has a plethora of qualified professionals at their disposal.

“[GenAI] is more effective for people who know what they want to talk about, who are aware of their issues,” he explained. “But there are patients with more complexity inside them that you need a human to sift through all that, ask the right questions, and dig deeper. It can’t deal with moderate to severe mental health issues.”

Jaffer offered a similar explanation, but associated it with a form of therapy called ‘transpersonal therapy,’ focused on inner healing through spirituality. “Though not widely practiced, it is still considered valid.”

She also suggested the possibility of AI potentially falling victim to the client’s manipulation due to its limited ability to appropriately challenge them. “Humanistic and psychodynamic therapies rely heavily on emotional engagement from the therapist. How can any of that work be carried out by AI if it has no capacity to emote?” Jaffer asked.

Human support, or lack thereof

The inaccessibility of good and affordable therapists continues to be a roadblock to the willingness of an individual dealing with mental health issues. The tiring process of screening, scheduling, and then finally sitting through therapy sessions is only exacerbated by the high costs, long waitlists, and of course, the emotional labour of repeating your story over and over again to find the ‘right’ therapist.

In addition to seeking professional help, leaning on your loved one is also a predicament when the world is busy promoting individualism in the name of self-care. Be it your anxiety spiralling out of control or just a workplace rant on a random Wednesday, more and more people are starting to prefer AI over talking to a real human in fear of ‘bothering’ them.

Talking about her concerns to ChatGPT was the last resort for Tanya and came after she was dismissed by her family and felt judged by her friends for feeling anxiety over a fairly new relationship.

“[ChatGPT] has become my only friend after I broke off my engagement,” she shared. “It understands that I feel sad even though it was my decision. Nobody else does.”

If all it takes for a person to feel cared for is a machine trained for active listening, providing validation and endless patience, then why does it matter if ChatGPT’s eyes can’t well up with tears in response to a heart-to-heart?

As South Asians navigate the relatively nascent waters of mental health treatment, the silent rise of AI as a confidant reflects both the paradox of our unmet emotional needs and the evolving ways we seek connection. The possibility of a chatbot replacing the intimacy of a human bond or the expertise of a licensed therapist is far, far away, but it’s still there.

For now, it is perhaps a great starting point for people to rethink the kind of support we offer each other and learn to be consistent, non-judgmental, and most importantly, accessible. Until we get there, some people may continue to find comfort in conversations with code, hoping to be heard.

Walk into one of those shops and you’re immediately hit by a whiff of synthetic strawberry and mint, and see a sign taped to the counter bearing a bold: “18+ ONLY.” Most residents of the city would say these shops are fairly new, so I ask the vendor how and when he got into the trade in the first place and who his average customer is.

He tells me he mostly sells to adults. As he recalls a friend’s AliExpress order of an e-cigarette with a ‘weird’ filter that sparked their venture into the business a few years back, a boy no older than 14 strolls in and pops open a sleek pod. He asks for a refill of his favourite Tokyo juice flavour in pineapple, and without a second glance, the vendor pulls out a bottle from under the counter and tops it up. The boy clicks the device shut and walks out, inhaling it deeply and leaving thick clouds of syrupy vapour in his wake.

Nicotine 2.0

The link between smoking and lung cancer may seem obvious now, but it wasn’t always so. In fact, the disease used to be so rare that doctors took special notice when they dealt with a case. It wasn’t until 1964 that the first report by the Surgeon General of the United States on the harmful health effects of smoking was published, making the issue less about consumer choice and more about epidemiology and public health.

Within a year, a law was passed in the US that required cigarette packages to be labelled with health warnings. Before long, cigarette advertisements on television and radio weren’t normal anymore.

Decades of public health efforts like indoor smoking restrictions and support to help people quit have led to smoking rates seeing a sharp decline globally. Now, newer technologies like vapes and nicotine pouches have reshaped the smoking landscape.

But it isn’t exactly nicotine itself that does the most damage — it’s actually the arsenal of carcinogenic substances it’s paired with in conventional cigarettes. Research scientist and harm reduction pioneer Michael Russell said in 1976 that people smoke for nicotine, but they die from the tar. And so people continue to seek healthier ways to deliver that fix.

Since vapes and nicotine pouches don’t “burn” tobacco or produce tar or carbon monoxide, they’re widely claimed to be safer than regular cigarettes.

Big tobacco firms like British American Tobacco (BAT) and Philip Morris International (PMI) have made substantial efforts to shift to new nicotine products and away from conventional cigarettes. As one person working for a big tobacco company in Pakistan told me in earnest defence of nicotine, “You can’t kill human curiosity.”

In London in September 2024, BAT launched ‘The Omni’, a summary of the company’s efforts to promote Tobacco Harm Reduction (THR) by encouraging smokers to switch to less risky alternatives. According to the company’s chief executive, Tadeu Marroco, the goal is to ensure that at least 50 per cent of its revenue comes from smokeless products by 2035.

While PMI maintains that the best choice for a smoker is to quit altogether, it describes THR as an alternative for adults who would otherwise continue to smoke.

The THR narrative has health experts divided on its legitimacy, but the general consensus seems to be that effective government regulation is crucial if we’re to maximise its potential benefits.

The clouded truth

But relentless marketing aside, health experts and policymakers worldwide remain sceptical of the long-term impacts of new nicotine products. Countries such as the United States, several in Europe, China, where most vaping products are manufactured, and even India are imposing bans or strict regulations largely due to worries about youth usage and unknown long-term effects. At least 31 countries have placed outright bans on the sale of e-cigarettes, while 73 have enforced sale restrictions and regulations.

In Pakistan, however, the market has thrived pretty much free from regulatory pressures seen elsewhere. Data obtained from the Pakistan Bureau of Statistics indicates that between July 2023 and June 2024, Pakistan imported a total of 750,590 e-cigarettes or vaporisers, with major imports coming from China, Hong Kong, Malaysia, the United Kingdom, and Russia. These figures, however, only reflect legal imports — it is believed that a significant number of vapes are smuggled into the country, particularly from China.

Earlier this year, Lahore held a vape exhibition at the city’s Expo Centre, which, according to the event’s website, was designed for industry enthusiasts to connect and explore the “future of vaping” in the country. A similar exhibition was scheduled to be held in Karachi on May 31; however, it was cancelled on the day of the event for unspecified reasons.

BAT entered the Pakistani vaping market through its subsidiary Pakistan Tobacco Company about a year and a half ago, initially offering disposable vapes in three variants — 700, 1,500, and 5,000 puffs. However, it exited the vape market at the start of this year due to heavy taxation on smokeless products and the inability to compete with smuggled products.

Large companies like BAT are compelled to pay government duties and taxes, which meant the retail price of their vaping product, Vuse, was much higher than products that got away with not paying duties. Although vaping has gained popularity in Pakistan, the high price of legal products made it difficult for BAT to compete in the market. An employee at BAT told me on the condition of anonymity that their disposable devices sold for around Rs3,000 and offer approximately 5,000 puffs. In contrast, cheaper alternatives offered 8,000 to 9,000 puffs for as little as Rs1,500. The vast difference in price and usage made these options far more appealing to the average consumer.

Pakistan Tobacco Company did not respond to a request for comment.

Repeating history?

On paper, the tobacco harm reduction narrative makes sense. If people are going to need their nicotine fix anyway, isn’t it better to deliver it in the least harmful way? After all, nicotine can help treat symptoms of attention-deficit/hyperactivity disorder (ADHD). As a 19-year-old from Karachi told me of his need to vape, “Just like when you wake up in the morning and have a cup of coffee. Suddenly, everything feels brighter, more colourful, and focusing becomes so much easier.”

But there’s a downside. When vapes are sold in every colour of the rainbow and flavours like pink lemonade, cotton candy, and bubblegum, kids inevitably get drawn in more than an adult smoker looking to quit.

According to pulmonologist Dr Saima Saeed from The Indus Hospital, vaping products are marketed in a way that specifically seem to target young people.

“If you go to any grocery store or corner shop, you’ll see behind the counter where cigarettes used to be, there will be a nice flashy advertisement for this chewable tobacco. The advertising is very flashy, and it has bright colours, and it’s saying you can use these products without smelling of cigarettes, and you won’t need to show anything in your hand because it’s like just a piece of gum in your mouth,” she said.

Rather than acting as a safer alternative, vaping and nicotine pouches are increasingly acting as gateways, according to Dr Saeed. Young people get hooked on nicotine through these products and may later transition to smoking cigarettes rather than avoiding them altogether. From a medical standpoint, nicotine is a drug. “It affects brain development, especially in adolescents whose brains continue developing into their early twenties,” Dr Saeed added.

Even though the first documented reference of an electronic cigarette is a patent granted to Joseph Robinson in 1930, the device never really became commercially successful until 2003 when 52-year-old pharmacist Hon Lik came up with the idea of an e-cigarette as a way to cure his own smoking addiction following his father’s death from lung cancer. Since most of these products are still relatively new, there’s no long-term research available to fully assess their actual impact.

“In Pakistan, systematic tracking of vaping-related injuries is nearly nonexistent. We’re simply overwhelmed with other respiratory issues; cigarette smoking itself still affects 12 to 15 per cent of the population, and that alone is a major burden,” Dr Saeed said.

She went on to explain the regulatory gap, with laws focusing specifically on cigarettes and “smoking”. This language allows the tobacco industry to exploit loopholes. In Pakistan, which is 14 on the list of top tobacco producers in the world and where industry players hold sway across sectors, regulation around new nicotine products is weak or absent. While advertising for cigarettes is banned, that’s not the case for vapes or chewable tobacco.

Pakistan is a signatory to the World Health Organisation’s Framework Convention on Tobacco Control (FCTC), which calls for banning advertisement, promotion, and sponsorship of tobacco products. But while the FCTC uses the word “tobacco,” Pakistan’s laws mostly say “cigarettes,” which leaves out products like vapes and nicotine pouches.

Although a Tobacco Control Cell existed under the Ministry of National Health Services Regulations and Coordination, it was disbanded in 2021. And as many Pakistanis know, there’s a vast difference between having legislation and enforcing it. For instance, there’s already a law that bans tobacco sales within 50 metres of a school, and yet, you’ll find tobacco products being sold right outside schools in many areas.

Recently, some headway has been made and Punjab Chief Minister Maryam Nawaz has directed the relevant departments to impose a ban on vaping in the province. The decision drew mixed reactions, with actor Iffat Omar criticising the move, arguing that such bans are ineffective and only fuel the black market rather than curbing access.

On the subject of harm reduction, Dr Saeed said, “Everything is relative. Some doctors will say that if you’re a smoker, it’s better to vape because there’s less immediate harm.” However, as she pointed out, even though that works in countries with better resources for people looking to quit, that’s hardly the case in Pakistan.

Instead, people may turn to vaping in an effort to quit nicotine, without realising that it requires a gradual reduction, and often without the professional support needed to taper off or quit entirely. “And at the same time, you have all this aggressive advertising to young people to encourage them to start using new tobacco products, clearly understanding that they’re gonna become lifelong addicts of nicotine.”

In a world steadily pushing cigarettes off the shelves, the tobacco industry is reinventing itself, not by backing down, but by pivoting and doubling down on newer nicotine-based products, all marketed as ‘safer’ alternatives to smoking, and all rapidly gaining popularity among young Pakistanis.

According to Dr Javaid A Khan, Professor of Respiratory Medicine at Aga Khan University, this growing trend is far from harmless. It’s alarmingly under-regulated and possibly setting up the next major public health crisis. “Cigarette smoking has become stigmatised; everyone knows it causes cancer and heart disease. But vaping? It’s seen as trendy, modern, even safe,” he said. “The truth is, it still contains nicotine, it’s highly addictive, and there are no long-term safety studies yet.” It’s essentially like repeating history.

Dr Khan believes that nicotine chewing gums are a good way to manage withdrawal symptoms for those looking to quit smoking. But, as he pointed out, famous actors promoting nicotine pouches as anything other than a crutch on television defeats the purpose. It’s hard to believe these products are supposed to be marketed as anything but gateways to nicotine use when you see them advertised by bright and bubbly Syra Yousuf, or Osman Khalid Butt hanging out on a beach.

Dr Waseem Iftikhar Janjua, consultant and advisor at the Sustainable Development Policy Institute in Islamabad, has been working on tobacco control for a few years, focusing on areas such as graphic health warnings, emerging nicotine products like vapes and heated tobacco, tobacco industry interference, and taxation policies.

He explained that while Pakistan has regulations in place when it comes to the demand, like bans on sales to minors, single-stick sales, and mandatory health warnings, there is a regulatory vacuum on the supply side, particularly around new products, such as vapes. These products, often flavoured to appeal to younger users, have rapidly proliferated in the absence of legislation.

He warned that the addictive nature of nicotine and the absence of long-term clinical studies make these products a serious public health risk. The global tobacco industry, he noted, is shifting from cigarettes to electronic nicotine delivery systems under the guise of tobacco harm reduction, a narrative he’s critical of. With Pakistan’s delayed policy response, regulating rather than banning these products is now the only practical solution, according to him.

While cigarette smoke has long been recognised for its harmful first-hand, second-hand, and even third-hand effects — which refers to the smoke lingering on surfaces like sofas and doorknobs — Dr Janjua noted that vaping introduces a new, less understood layer of concern, a phenomenon he dubbed “fourth-hand smoke”: the visual appeal and fascination with vaping, especially among youth, who are drawn in by thick vapour clouds and tricks like smoke rings.

“These devices, often no larger than a USB stick, are discreet and go unnoticed by parents or teachers. They don’t burn tobacco but use a coil to heat liquid nicotine, which gives off a sweet smell and can be used throughout the day,” he said. “Initially expensive, the local market is now saturated with cheaper Chinese products.”

Underage? No problem

Although most vape shops mushrooming over the country claim to only sell vaping products to adults over the age of 18, most teenagers and young adults who regularly vape say it’s not difficult to purchase one, regardless of how old you are.

There’s also an aspect of convenience that draws people in. Arsalan*, an 18-year-old architecture student from Islamabad who has been actively vaping for over a year, said he started in the winter because he “didn’t want to go out in the cold [to smoke] and needed something easier”.

“I could just access it right away,” he said, adding that he hasn’t faced any difficulty when it comes to buying products from local shops. He said his 23-year-old brother was able to successfully use vapes as a crutch for a few months and eventually quit smoking altogether. Fruity flavours, he pointed out, are particularly appealing. “Traditional cigarettes have a very bitter taste. But when you have fruity flavours, it kind of feels like fireworks in your mouth.”

Ali*, a 19-year-old business student at a private university in Karachi who has been vaping for five to six years, said you’ll hardly find a boy in his circle who doesn’t vape. Like most young adults, he got into the habit out of curiosity and developed a dependency a few months down the road. He hasn’t faced any difficulties buying vapes either.

An A-Level student from Karachi said vaping is common in his school, despite restrictions. He started vaping in Grade 10 or 11, and it later became a way to relieve stress and cope with anxiety. He shares a 30ml bottle with his brother, which lasts a month. Even though some shops do ask for a CNIC before selling a product, he said there are always others that don’t.

He once quit vaping entirely and noticed significant health benefits, like being able to breathe better at the gym, but the smokeless stint didn’t last long. Vaping helps him focus, especially at night, he said, and quitting is hard.

Twenty-two-year-old Bilal*, a media student in Islamabad, began vaping in 2022, following a few years of smoking cigarettes. As someone studying outside of his hometown, he initially turned to vaping as a more discreet way to consume nicotine, especially to avoid the lingering smell of cigarettes when returning home. “Vaping felt like a cleaner alternative,” he said. Bilal, who doesn’t like the aftertaste of flavoured vapes, considers himself addicted to nicotine more than vaping.

Vaping’s accessibility compared to smoking means people tend to use it more frequently and often in places where they wouldn’t normally light up a cigarette, leading to increased nicotine intake, sometimes without even realising it. As one 39-year-old woman put it, “I feel like the amount of vaping I do is probably equally, if not more, damaging.” After switching to vaping in hopes of quitting cigarettes, she found herself using liquid with 50 mg of nicotine just to feel the same effect. “Smoking makes you conscious because of the smell. You have to stand outside and smoke, so that reduces your time. But with a vape, it’s so accessible to you. I can wake up and I can do it, I’m driving and I can do it. I’m sitting in my office, and I can do it. So I feel like that is definitely more harmful than smoking.”

Another adult smoker, who switched to vaping around a year ago to avoid the lingering smell of cigarettes, said, “With cigarettes, I’d smoke two packs a day. But it was still less compared to vapes. Every time I wanted to smoke, I’d have to step out. Outside the house. Or at work, there would be designated spots. To vape, I can just get up in the middle of the night, go to the bathroom and vape there and come back. Or I’m vaping in the lounge or in the drawing room or wherever. There’s no smell that lingers so no one’s gonna know someone was vaping here.”

To him, the fruity flavours and bright colours are not appealing. He believes they’d appeal far more to “teenagers”.

The shop owner whose entry into the market was sparked by an AliExpress order believes the ban on shisha in public spaces caused vaping to gain attention. Unlike cigarettes, which contain a fixed nicotine strength of about 15 to 20mg per stick along with harmful substances such as tar, vapes allow users to control their nicotine intake from zero up to 50mg, or 5pc strength. So, according to him, it’s a healthier alternative for those looking to quit smoking.

Early vape devices were large and lacked the refined pod systems available today. While vaping is supposed to help users quit cigarettes, many customers continue to use both, which defeats the purpose. “If someone really wants to quit, they can quit directly too,” said the shop owner, adding that when new customers come in, he inquires about their smoking history to suggest a suitable device.

Daniyal, another vape store owner in Karachi who has been working in the industry for the past four years and running his own brand and shop for the last two, described the sector as rapidly evolving. Initially employed at another vape shop, his curiosity about the origins, side effects, and benefits of vaping led him to start his own business. He said that all vape hardware and liquids are manufactured abroad, with no manufacturing currently taking place in Pakistan.

He observed a major shift in social attitudes towards vapes. “In the past, people got in trouble for smoking cigarettes. Now, if someone aged 18 to 22 uses a pod vape, no one at home objects because there’s no smell,” he said. “Even when you sit with others, you don’t feel awkward because there’s no tobacco odour.”

The idea that vaping and smoking differ comes mainly from how nicotine is delivered and the chemicals inhaled. Since battery-powered vaping devices heat nicotine, flavourings, and other chemicals into an aerosol that is inhaled, it isn’t technically “smoking.” But for those exposed to the aerosol fumes, the difference can feel minimal. Recently, actor Hina Khwaja Bayat spoke about her annoyance with vaping, saying that she does mind if someone vapes in the same room as her.

Peshawar-based non-profit organisation Blue Veins, which works on gender-based violence and non-communicable diseases, has recently expanded its advocacy to include the regulation of e-cigarettes and vapes. Operating under the Khyber Pakhtunkhwa Alliance for Sustainable Tobacco Control, a civil society collective comprising doctors, lawyers, and journalists, the group is attempting to raise awareness about the absence of a legal framework governing the sale, marketing, or storage of vaping products.

“There’s no regulation. No signage, no age restriction, no health warnings,” Qamar Naseem, a representative of Blue Veins, said, stressing how easily accessible vapes are to younger people. He said there’s a widespread misconception that vaping is safer than smoking. “Nicotine is globally recognised as a poison. If it’s a drug, it should fall under drug laws,” he argued, adding that multiple countries have already banned or strictly regulated vaping due to its health risks.

The planet is taking the hit

Beyond health concerns, disposable vaping products pose another unique problem that often goes largely overlooked: these single-use devices contribute to electronic waste, as they contain lithium-ion batteries, plastic components, and toxic metals that are rarely recycled. So every time a disposable vape is discarded improperly, it ultimately contaminates landfills and water sources, adding to the fastest-growing solid waste streams in the world.

In Pakistan, informal e-waste recycling activities generate organic flame retardants, chemicals added to materials like plastics, textiles, and coatings to make them more resistant to fire. While these flame retardants are ordinarily crucial for safety in certain products, their generation by improper disposal of e-waste can be deadly for labourers working in these areas.

A study conducted on four recycling sites in Karachi — Jacob Lines, Surjani Town, Lyari, and Shershah — revealed that the environment from Shershah and Lyari was highly contaminated with flame retardants. This can have severe health effects like endocrine and thyroid disruption, immunotoxicity, reproductive toxicity, cancer, and harmful effects on foetal and child development. As Jabir Hussain Syed, one of the study’s authors and an e-waste researcher, pointed out, the plastic pods and cartridges inside vapes and e-cigarettes can be particularly problematic for both the environment and health.

Around the world, countries are waking up to the risks of vaping by tightening regulations or imposing outright bans. As more young Pakistanis turn to brightly advertised vapes in fun, fruity flavours, will the government take proactive steps or wait for a full-blown crisis to do something?

*Names changed to protect privacy

The course, titled Know Your Body: A Girl’s Guide to Growing Up Healthy, starts June 25 and is structured into four interactive modules, offering a safe and inclusive space for young women to learn about their bodies from certified professionals from fields of medicine, nutrition, psychology and human rights. It aims to dismantle stigma, promote self confidence, and equip participants with tools to navigate adolescence with dignity.

The participants will gain essential knowledge about menstrual health, nutrition, mental well-being and bodily autonomy.

“This course is designed to give girls the information many of us wish we had growing up,” said the organisation’s founder and human rights activist, Iqra Parveen Awan.

“From your first period to body image, peer pressure, or knowing your rights — this space is about being informed and supported.”

Each module will be online and span an hour and a half. The first module will discuss menstrual health with Dr Rabia Hashmi, an assistant professor from Fatima Jinnah Medical University. The second will focus on nutrition for the body with clinical dietitian Samar Jawed. The third will be conducted by psychologist and art therapist Rakia Raza and discuss emotional health and eating disorders. The last module, by Awan herself, will be on rights, confidence and moving forward. The course will include quizzes, interactive activities, and expert guidance during every session.

The course will be conducted bilingually, in both English and Urdu, with a preference for the latter to help girls learn and understand better.

In a conversation with Images, Awan said it was important to hold this course because menstruation is a natural process but there are stigmas associated with it that cause confusion in young minds about their bodily changes that not only cause a loss in confidence but also hinder daily activities.

“This course and awareness relating to menstruation and growing body changes are essential for young girls to adopt the body changes in a healthy way without losing their childhood or themselves to myths or misconceptions,” she explained.

Awan said young women and girls were often completely unaware about menstruation and bodily changes because the topic was taboo and the only source of information was mothers — who could be uncomfortable talking about it — or other young women who were equally unaware and spread myths about menstruation.

“A very prevalent myth is that showering or bathing during periods can cause diseases or even infertility. This myth is still being circulated and believed in many areas of Pakistan. A number of misconceptions relating to menstrual products are also common, creating a state of confusion and misinformation.”

The best time to educate young girls on this is when they are around 10 or 11 years old, since that’s when most young girls get their periods. By educating them with age-appropriate information, they are able to learn and prepare before they hit puberty, without thinking of it as a burden.

“Young girls, completely unaware of these processes, tend to build a kind of resentment towards this natural process and even their bodies as well, so preparation beforehand is needed,” Awan said.

Talking about PCOS, the condition her organisation predominantly focuses on, Awan discussed the importance of talking about PCOS and signs to keep an eye out for, explaining that menstrual irregularities were the most common symptom.

“I believe talking about healthy and unhealthy menstrual cycles is the key to early diagnosis, treatment and management. Young girls who are completely unaware of the problem that comes with menstrual irregularities waste a lot of time in negligence and not seeking help, which leads to aggravated symptoms, causing more distress.”

Awan said that PCOS Helps advocates for the inclusion of women’s health and hygiene as a mandatory course in the educational curriculum to help them learn about PCOS, aid in early diagnosis, treatment and management.

“Making this course mandatory for all genders and not keeping it particularly for girls will help us curb the cases of domestic violence relating to infertility as well. That’s why I believe that PCOS is not a health issue in Pakistan; it is a human rights issue and should be taken as one.”

The registration deadline for the course is June 18, and those interested can register here.

Issuing fresh guidelines on how to halt FGM, the UN health agency highlighted the important role played by health professionals in detecting the widely condemned practice and supporting survivors.

But it said there was evidence to suggest that health workers in several parts of the world were themselves often called upon to perform the procedure, rather than it being done by local communities.

“Female genital mutilation is a severe violation of girls’ rights and critically endangers their health,” said Pascale Allotey, WHO’s head of sexual and reproductive health and research.

“Health workers must be agents for change rather than perpetrators of this harmful practice and must also provide high-quality medical care for those suffering its effects,” she said.

FGM involves the partial or total removal of the female external genitalia or other injuries to the female genital organs.

It can lead to serious health problems, including infections, bleeding, infertility and complications in childbirth.

An estimated 230 million girls and women alive today have undergone FGM, according to UN Women, with the practice typically carried out on young girls before they reach puberty.

Significant effort has gone into halting the traumatic and painful procedure, which is linked to cultural norms and has no health benefits.

‘Unintentionally legitimising FGM’

WHO highlighted that since 1990, the likelihood of a girl undergoing the procedure has decreased threefold.

However, it remains common in some 30 countries, with around four million girls remaining at risk each year, it said.

The UN health agency said the medicalisation of FGM risked “unintentionally legitimising the practice”, thereby jeopardising the efforts to root it out.

It called in its new guidelines for professional codes of conduct that expressly prohibit health workers from performing FGM.

It also stressed “the need to positively engage and train health workers for prevention”.

“Research shows that health workers can be influential opinion leaders in changing attitudes on FGM,” said Christina Pallitto, a WHO scientist who led the development of the new guidelines.

“Engaging doctors, nurses and midwives should be a key element in FGM prevention and response.”

In addition to prevention, the new guidelines include clinical recommendations to help ensure that FGM victims receive empathetic and high-quality medical care.

Highlighting the large variety of short- and long-term health issues caused by the practice, the WHO said: “Survivors may need a range of health services at different life stages, from mental health care to management of obstetric risks and, where appropriate, surgical repairs.”