World Mental Health Day: Why the Middle East Has Some of the World's Highest Anxiety and Depression Rates
- Sarah El Nabulsi, M.Sc., M.A., M.A.
- Jul 8
- 5 min read
MBC1 — FI OSBOU3A · October 11, 2019
On World Mental Health Day, Ms. Sarah El Nabulsi, M.Sc., M.A., M.A., DHA Licensed Clinical Psychologist, joined the hosts of MBC1's Fi Osbou3a to explain what mental health actually means, why the Middle East and North Africa carry one of the highest regional burdens of anxiety and depression in the world, and why our part of the world remains so reluctant to talk about it.
Mental Health Isn't the Absence of Distress
The segment opened with a definition that I think more people need to hear: according to the World Health Organization, mental health is not necessarily a state free of any distress. It is a state in which a person is able to cope with the ordinary challenges of daily life and still function toward their goals. WHO defines it as "a state of mental well-being that enables people to cope with the stresses of life, realise their abilities, learn and work well, and contribute to their community." Struggling occasionally doesn't mean something is wrong with you — the question is whether you can still cope and function through it.
The hosts also raised a sobering statistic that I want to repeat here: for every completed suicide, there are an estimated 20 attempts — a ratio the WHO has used consistently in its global suicide prevention data. At the time of this interview, roughly 80% of suicides were reported to occur in low- and middle-income countries, which the WHO directly linked to a lack of accessible mental health support and services. (Note: WHO's most recent fact sheet, using 2021 data, now puts this figure at 73% — still the large majority of global suicides, even as the exact proportion has shifted slightly with updated reporting.)
Why Our Region Carries Such a High Burden
When the host asked, half-joking, whether we're "suffering from anything" here, my answer was serious: yes. At the time of this interview, the Middle East and North Africa had some of the highest recorded rates of anxiety and depression in the world — around 4–4.5%, against a global average of roughly 2.5–3.7%. (Updated context: more recent Global Burden of Disease estimates put MENA anxiety disorder prevalence at approximately 6.1%, compared with a global average of about 4.05% — still meaningfully above the rest of the world, and GBD 2021 data separately shows this region carrying one of the highest depression-related burden and mortality rates of any region globally.)
Some people in this part of the world don't take mental health seriously, treating it as taboo, or something not worth discussing given what they see as bigger problems — ongoing conflict, loss of life, instability. I understand that framing, but it misses something important: we care enormously about productivity in this region, and these rates show that anxiety and depression are directly undermining exactly that. Sustained states of distress shut down activity in the prefrontal cortex — the part of the brain responsible for clear thinking, planning, and decision-making. Low mood and chronic stress aren't separate from our ability to perform. They are the mechanism working against it.
Learning to Take Stress Seriously
I was asked how we take care of our mental health day to day, and I pointed to what the UAE has already done well: giving real, visible institutional attention to this topic, in a way I'd encourage other countries in the region to follow.
On an individual level, we need to be directive about our lives rather than letting stress accumulate by default. One of the biggest obstacles I see is that people in this part of the world tend to tolerate extremely high levels of stress before acting — and that tolerance is exactly what prevents proactive, effective stress management. This kind of chronic over-tolerance is what leads to frequent burnout, depression, and anxiety.
If you are part of the working population — which is most of us — it matters to notice when your stress has been elevated for a sustained period, and to consciously choose to slow down and recover. This can be as concrete as looking at your calendar and deliberately scheduling in activities that diffuse tension: things you enjoy, things you're curious to learn, anything outside the loop of work-home-work. That loop, on its own, is one of the most common patterns I see driving burnout in this region.
The Culture of Silence — and Why It Persists
One of the hosts raised something I hear constantly: people who seek mental health support here tend to do it quietly, hiding it from family, friends, and the public — while in Western countries, seeking support is often treated as something healthy and even admirable.
My answer is rooted in culture, not individual failure. Part of Arab culture places real value on projecting an image of perfection to the outside world — formality and privacy outside the home are deeply ingrained, and you can trace this back through generations, visible even in old Arabic poetry, not just in how children are raised today.
I believe one major driver of this is that in interconnected, collectivist cultures, people tend to generalise quickly: if something negative is attached to you, it becomes attached to your family name as a whole. This creates a real fear — not just of personal judgment, but of judgment extended to your entire family. That's a very different social calculation than in individualist Western cultures, and it produces a kind of cognitive bias that keeps people from evaluating their own mental health accurately or acting on it. It's part of why it mattered, that same World Mental Health Day, that public figures like Britain's Prince William spoke openly about their own mental health struggles and how they coped — visible examples matter in shifting a culture like ours.
I keep returning to the same point with clients and audiences alike: our culture is achievement-driven, and mood plays a much bigger role in achievement than we tend to credit it for.
You Don't Need to Be in Crisis to Ask for Help
Finally, I addressed a misconception I hear often: that therapy is only for people who are suicidal or in acute crisis. It isn't. Many people struggling with something much milder — work-life balance, everyday anxiety — hesitate to seek support because they assume their problem "isn't serious enough."
My advice is the opposite of what most people assume: come in as early as possible, at the first signs of distress, before things escalate. Depression, once fully established, is a far more advanced state that can take months — sometimes much longer — to reverse. Catching distress early gives a significantly better prognosis.
I'd like our culture to talk about this more openly, so that friends and family can support one another the way we naturally would with any other health concern — noticing when someone we love has gone quiet, has lost motivation, and simply saying, "I've noticed you've seemed different lately — why don't you talk to someone?" It's no different from how we treat a worsening cold: we don't wait for it to become severe before we see a doctor. We treat it seriously at the first signs, long before it becomes something much harder to reverse.
About Ms. Sarah El Nabulsi
Ms. Sarah El Nabulsi, M.Sc., M.A., M.A. is a DHA Licensed Clinical Psychologist (License No. DHA-75083705) based in Dubai, and UAE Director of the Transcendental Meditation Organization. She has been featured on MBC, MBC1, Sky News Arabia, Dubai TV, and BBC Arabic, and is the founder of the online courses Anxiety 101 (Level 1) and Master Yourself (Level 2).
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