Nausheen Shah has spent the last few years deep in the trenches battling her anxiety and depression.
Roughly seven years ago, the actress first began to feel a sort of heaviness that would follow her throughout the day. At night she couldn’t fall asleep. She would cry all the time and stay holed up in her room a lot. There were even times when she felt like she could no longer read her scripts.
“I would start off at my shoot totally fine but all of a sudden I don’t know what would overcome me. Co-stars were having to rush me to the hospital,” she recalls. “It was a time of deep embarrassment. People thought I was pagal, like I had gone mental.”
But Nausheen had not, in fact, gone “mental”.
What she was actually experiencing was a panic attack, which is an episode of intense fear that is accompanied by at least four of a set of symptoms. Some of the common symptoms can include an increased heart rate, sweating, trembling or shaking, shortness of breath, and a fear that the person is losing control or “going crazy”.
When Nausheen went to a doctor, he didn’t bother to try and pinpoint what was causing her distress nor did he discuss with her treatment options (like medication coupled with cognitive behavioural therapy -- a frequent treatment for panic disorder).
Instead, he handed her a quick-fix in the form of a prescription for Lexotanil, which is a highly addictive anti-anxiety drug. She went for a second opinion. This doctor not only okay-ed the medication, he told her to take as many as she felt she needed.
Initially, the medicine brought nothing but relief. Anytime she felt the familiar pang of a panic attack coming on, she would take a pill and within ten minutes she would be blissfully and sufficiently numb enough to continue her day. But over time, she built up a tolerance to the Lexotanil. Eventually she was taking ten to twelve pills daily just to function.
Then, one day, she fell apart in front of Shahroze Sabzwari. She now credits him for essentially saving her life. When he asked her what was going on with her, she simply told him she could no longer do it -- any of it -- and, immediately, he got her an appointment with a doctor he trusted.
“This doctor told me I was definitely on the wrong meds,” she recalls. “The Lexotanil had been good in the moment but it came with massive withdrawals in the long run.”
This new doctor started Nausheen Shah on new, safer anti-anxiety medication. But, her struggle was not yet over. “The doctor advised that I spend time with myself, on myself. He told me to spend time thinking about what my triggers were,” she tells me.
While it was incredibly difficult to dig deep inside herself in this way, she pushed through the discomfort. By the time Ramadan came around this year she felt as if she had finally made a breakthrough.
“I finally realized that I need not only the right type of medication but that I also have to change a lot of bad habits, to get myself away from a lot of negativity, to start putting myself first, and, most importantly, I had to restore my connection with Allah,” she tells me. “Basically, I had to give up things that weren’t acceptable for my health and my religion.”
Today, Nausheen Shah is a different woman. She is completely focused on her career. She also spends a lot more time on her health. Right now she’s completing an online health class. And, she does yoga and pilates regularly. She also prays five times a day and has pretty much completely pulled out of the industry social scene for the sake of her sanity.
I ask if it’s tough now that her social orbit has shrunk? She tells me she has little interest nowadays in giving her energy to events and people that don’t matter. Plus, an alcohol and drug-fueled party circuit was never really her thing anyway. We talk about her recent appearance on Ahsan Khan’s talk show, which has since gone viral.
“Why should I be ashamed if I have a disorder?” she challenges me. “We only ever want to talk about an actor’s sense of style, her roles or her controversies. And I’m sick of this.”
I sense in her an underlying pit of outrage and so, I decide to probe further.
“Xanax and Lexotanil are being sold wily nily,” she astutely points out. “This is a country where we will happily smoke hash to calm ourselves down because we have no actual awareness of mental health and how to treat it. And the really good doctors are just not accessible [to regular people].”
She recalls the time she spent desperately trying to wean herself off of Lexotanil. At one point she went back, in a desperate bid for her life, to the same doctors that had prescribed her the Lexotanil in the first place.
“I remember saying to them, ‘you got me on this... now you get me off’ and I just remember them looking at me and saying ‘but, everyone takes it... it’s fine.’”
Being no stranger to the frustrating and complex world of psychopharmaceuticals, I offer up my own story about the time I was visiting Pakistan and went to the Lahore Airport pharmacy in search of a sleep aid. The guy behind the counter offered me Xanax because, according to him, that was what everyone takes to help them sleep.
I’m no stranger to Xanax. It’s something I’ve been prescribed in the past by my own doctor in Washington D.C. for my generalized anxiety disorder (GAD). I know what Xanax can do to a person. Specifically, I remember the way it feels to try and wean off of it, which is why I remember standing there at the Lahore Airport with my mouth hanging open, shocked to see such a heavy duty, highly addictive sedative being sold so carelessly at a tiny stall.
Still, I bought a ten-pack, feeling sadly defiant for having turned down the guy’s efforts to upsell me the sixty-pack.
A recent Washington Post article declared that “we live in the age of anxiety”. But even though so many are suffering, so few are getting the help that they so desperately need. And nowhere is under-treatment a reality than in Pakistan. According to one study, in western nations, one in six people receive proper treatment. In the developing world, this number plummets to one in 27 people.
While the exact prevalence of anxiety disorders in Pakistan has not been studied in-depth, a Karachi-based study from 2007 describes the high prevalence of anxiety as “alarming”, particularly for women.
A 2016 report that reviewed studies from across Pakistan found that being a female was one of the major risk factors for developing anxiety and depression. This same report found the prevalence of anxiety and depression across Pakistan ranging anywhere from 22% to as high as 60%.
I share these dismal (and likely, underreported) statistics with Nausheen Shah who remains hopeful.
“After my TV appearance, there was a huge and very positive response. I didn’t get a single message or call from someone telling me not to do this. Everyone was supportive and there were even people wanting the number of the doctor I see,” she recalls.
I ask if she thinks Pakistanis are ready to get real about mental health, to talk about the hard stuff that so many of us struggle with -- sometimes so openly.
Without so much as a pause, she tells me: “Pakistan is 100% ready.”