Afghans are often traumatized and depressed. Experts say that the mental health system is not equipped to assist them.
Sources said that desperate Afghans resort to self-medicating using antidepressants and anxiety medication.
Insider was told by the former Afghan health minister that there is a growing suicide crisis.
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Ghulam* stated, "My education is destroyed, my dreams and everything are lost." "There is no future for us, there is nothing here."
Ghulam, a 21 year-old Afghan man, spoke out to Insider about his declining mental health since the Taliban took over Afghanistan in a massive offensive.
Ghulam stated that he had self-harmed and contemplated suicide while contemplating his future under Taliban rule, which strictly adheres to Islamic Sharia law.
"I self-medicate using Pregabalin. Because one pill won't work, I take three. It helps me to calm down and forget all my problems," Ghulam stated.
Pregabalin can be used to treat generalized anxiety disorder.
Two Afghan men are seen using drugs along a Kabul road. Oliver Weiken/Getty Images
Insider was told by sources that people with mental health problems are increasingly turning to Afghanistan for help. They have been using antidepressants and anti-anxiety medications in Afghanistan as a way to find solace.
Ghulam stated that in Afghanistan, any type of medicine can be purchased from a pharmacy without a prescription. There are also black markets, where you can buy anything. Ghulam said that street vendors often sell counterfeit prescription drugs and that there are many of them in Kabul.
Ghulam stated that many of his friends overdose. "They take one medication, but it's not working properly, so they're taking multiple, three, or four medications simultaneously just to improve their mood."
He stated that his friends often take the antidepressants fluoxetine and escitalopram as well as Pregabalin. They will often experiment with different combinations, and then recommend them to one another.
Ghulam said that people are purchasing medications without consulting their doctor.
Ghulam stated that many Afghan youth are self-medicating using antidepressants such as fluoxetine. Stephen Chernin/Getty Images
Afghan psychiatrist Dr. Wais Aria heads Tabish mental health non-profit Tabish. He said that Afghanistan's mental health infrastructure is already suffering from a series of problems. These include a collapsed economy, violent threats, and a slew of other social issues.
He said that "demand is high, and services are very limited." People are seeking antidepressants or sedatives because they don't have any real support to cope with stress and mental health issues.
A nation deeply traumatized
According to Lyla Schwartz (managing director of Peace of Mind Afghanistan's psychological support consultancy), people are turning to fake medication to "numb the truth." She spoke to Insider during a telephone call.
She said that Afghanistan's people were already traumatized from decades of conflict and poverty.
According to a 2018 survey by the European Union, 85 percent of Afghanistan's population had witnessed or experienced at least one traumatizing event. A 2019 study by the International Psychosocial Organisation, (IPSO), found that 70% of Afghanistan's 40 million inhabitants needed mental health support.
Former Afghan public health minister Dr. Wahid Mamrooh stated to Insider that there has been very limited access to mental health professionals.
According to the latest data from the World Health Organisation (WHO), there are only 0.3 psychologists for every 100,000 Afghans. In comparison, the US has 30 psychologists per 100,000 people, which is 100 times more.
Majrooh stated that large swathes, especially rural, of the country have relied on counselors without any training and who "don’t meet the expectations of this system."
He said that the situation in the last month is worsened and "exacerbated".
Although psychologists are in greater demand than ever before, they are fleeing the country.
Aria, who was a Kabul psychiatrist until last month, stated that political turmoil had reduced the number of Afghan medical professionals. He said that there are many doctors and therapists who have left Afghanistan because they don't feel safe.
Aria fled Afghanistan for the USA on August 25, after he stated that he was afraid his work with NGOs and psychiatric care could make him a target of the Taliban.
Judy Kuriansky is a Columbia University Teachers College psychology professor and representative of the United Nations NGO. She helped other psychiatrists escape. Insider reported that they are more needed than ever but cannot continue to operate. Their lives are in danger."
According to The Guardian, one of the country's most respected psychiatrists was taken from his job last week after receiving death threats.
Kuriansky said it was unfortunate, but necessary, that these mental health professionals be evacuated. He fears the consequences are that "the whole mental health system in Afghanistan will collapse."
Experts say that women are most at risk.
"If it weren't for my family, would I end my life?"
Women, whose lives were already severely restricted by the Taliban's rise to power, can no longer work with men and are not permitted to leave their homes without a male guardian.
Zahra* (25), a doctor in Kabul's maternity ward, said that although most women are unable to work at the moment, the Taliban allowed Zahra to do so because there is a shortage of Afghan doctors.
She claimed that she was harassed at Taliban checkpoints because she went to work without a male chaperone. Taliban fighters often call women derogatory by speaking to them.
Zahra stated that her mental health has been negatively affected by the restrictions placed on her life.
New restrictions have been imposed by the Taliban on women's lives. This includes a strict dress code. Getty Images/Aref Karimi
She told Insider that she was not like this in the future. The future is uncertain since the Taliban took control. I am really depressed. "I wonder what my future will look like.
Zahra stated that she saw a psychologist to get the antidepressant fluoxetine. She also helped her obtain it at a reduced price as a favour. Zahra stated that she is afraid she won't be able afford to buy more when she runs out.
Zahra stated that the pills are only able to help so much. She stated that she is concerned about her safety, but she cannot work because she is the sole breadwinner in her family's life since her father died.
Zahra stated, "If it weren't for my family I would end my own life because I don’t know what Taliban will do to me."
The suicide crisis in Afghanistan is imminent
She is not the only one who has suicidal thoughts. Insider was contacted by multiple Afghan interviewees who said they were considering suicide because they felt helpless in the future.
Zahra stated that one of her neighbors died by suicide when they jumped from the roof of their home.
"Living with this trauma is the worst thing you can do for your future. Many people feel helpless and consider ending their lives. She said that people are saying, "I wish we weren’t even born."
Majrooh, a former health minister, said that he is worried about Afghanistan's imminent suicide crisis. He said, "I can assure you that in a few months, the suicide rates, particularly among the elite and educated who have enjoyed their positions in past years, will be just astonishing."
Ayesha Ahmad, a senior lecturer in Global Health at Saint Georges University of London, whose research focuses on Afghan trauma and suicide prevention, stated that Afghan women were already at an alarmingly high level of suicide risk even before the Taliban took over.
The BBC reported that around 3,000 Afghans try to end their lives each year according to data from the Afghan Independent Human Rights Commission. An estimated 80% of them were women.
Ahmad stated that Afghanistan is a notable exception to global trends in the sense there are more suicides of females than males.
Ahmad stated that gender-based violence is a major motivator for women taking their own lives. This trend is only likely to get worse.
A psychiatrist from Afghanistan talks to patients at the Kabul Mental Health and Drug Addicts Hospital. Rahmat Gul/AP
Afghans face uncertain times under the Taliban regime. Some see suicide or self-medication as their only options.
Many have not been able access professional help as the mental health system is crumbling around them. Those who have had access to professional help, such as Zahra and others, have found little comfort.
Her psychologist's advice to her to "stay strong" and to "try to not think too much is still unmoved.
*We gave pseudonyms some interviewees in Afghanistan in order to protect their identities.
