“Poverty is an ethical concept, not a statistical one”. — John Wall, World Bank, 2006
IN nuclear-powered Pakistan nearly 40-50 per cent of the country’s 240 million people live below or around the poverty line, fighting for daily survival. But millions more are extremely vulnerable. As John Wall said, “The incomes of a very large portion of the population are just above and below the official poverty line. This clustering around the poverty line also implies that families are quite vulnerable to falling into poverty with the slightest run of bad luck. A drought or bad agricultural year, an illness of a breadwinner, rises in prices of basic commodities — all these can cause families to fall into poverty.”
In Pakistan, poverty is often discussed in numbers, percentages, GDP ratios, and economic growth rates. Policymakers debate fiscal reforms, economists analyse inflation trends, and politicians promise relief packages. Yet, what remains largely ignored is the psychology of poverty — the effect chronic deprivation has on the human mind, behaviour and social fabric. Poverty is not only an economic condition but also a psychological experience, one that influences how millions of poor in Pakistan think, feel, and act every day.
Behind statistics lie complex emotional realities: uncertainty, humiliation, despondency and a persistent sense of powerlessness. Poverty is not merely about lack of money; it is about lack of dignity and agency. It distorts one’s sense of self, narrows cognitive functions, and traps individuals in cycles of stress and short-term survival. Inflation, unemployment, and debt create an unbearable cognitive load for the poor largely ignored by policymakers and health professionals alike.
One of the most damaging psychological aspects of poverty is chronic uncertainty. A poor family in rural Sindh or an informal daily wage labourer in Karachi lives on the edge perpetually, asking: ‘can I earn enough to feed my family today’? This constant state of worry leads to prolonged physiological arousal that impairs memory, attention, and emotional regulation.
Poverty is not only an economic condition but also a psychological experience.
Children raised in such environments often exhibit heightened anxiety and difficulty concentrating in school. Adults experience exhaustion, irritability, and depression. Over time, the brain becomes wired for survival rather than growth. When survival is the priority, planning for the future becomes a luxury. This explains why many development programmes fail: they expect long-term rational decision-making from individuals whose daily lives allow no psychological space for it.
Poverty is hugely stigmatising as the poor are blamed as being lazy, uneducated, or irresponsible. While the rich can argue that they acquired their wealth through merit, ignoring advantages such as education, inheritance and class that may have helped to secure it, the poor begin to blame themselves for their failures, even when they can do little to change their circumstances.
This ‘internalised stigma’ is not only unfair but psychologically damaging, as the poor see themselves as inferior or undeserving. They remain invisible and excluded from any decision-making. They are subjected to daily indignities of humiliation, lack of justice, exposure to pollution and violence that take a cumulative psychological toll.
For Pakistan’s young population — over 60pc under the age of 30 — poverty carries a huge psychological burden. In a society that celebrates success and wealth, poor youth face intense pressure and shame. They are told to “work hard,” yet find few opportunities. This gap between aspiration and reality leads to frustration, anxiety, and turns many youth towards anti-social activities. No wonder every young person wants to leave the country.
At the same time, many poor see the immense wealth displayed by other Pakistanis. The number of luxury cars on our roads, the huge palatial houses, the manicured lawns of the gated communities and golf courses and the unfettered spending in our weddings are there for all to see. The poor cannot even dream of this, creating a ‘cognitive dissonance’ within them leading to psychological reactions including anger, frustration, depression and despondency.
Pakistan already faces a mental health crisis, with one in four people estimated to suffer from depression or anxiety, a figure significantly higher among low-income populations. Yet, mental health remains a neglected issue in public policy.
For the poor, access to mental healthcare is nearly impossible. The cost, stigma, lack of awareness and accessibility to the few services make psychological care a privilege of the wealthy. Consequently, emotional suffering is often expressed through physical symptoms — fatigue, headaches, or chronic pain — and misdiagnosed and treated inadequately. This neglect perpetuates the false notion that the poor are ‘resilient’ or ‘used to suffering.’ In reality, they have no choice but to silently endure the psychological distress.
Tackling the psychology of poverty requires going beyond mere welfare programmes. Economic reforms alone cannot heal the emotional wounds of chronic deprivation. Pakistan needs policies that restore dignity, agency, and hope. Social protection must be designed not just to provide cash but to build confidence, for example through microcredit programmes that trust women as decision-makers, or job initiatives that give youth a sense of purpose.
Importantly, the political discourse must shift away from portraying the poor as passive recipients of charity. They are active agents surviving against immense odds. Recognising their resilience, rather than pitying their condition, is the first step toward social healing.
Poverty in Pakistan is not only a failure of economics; it is a crisis of the mind. It erodes hope, corrodes trust, and diminishes the belief in collective progress. For millions of Pakistanis, poverty means living with daily psychological strain that no relief package can quantify.
If Pakistan truly seeks inclusive development, it must place mental well-being at the heart of its poverty alleviation agenda. The fight against poverty is not only about raising incomes; it is about restoring dignity, rebuilding confidence, and healing minds.
To end poverty, we must first understand — and care for — the psychology of the poor.
The writer is a consultant psychiatrist.
