Interestingly, depression is not a poor man's disease. Everyone who is poor and has nothing is not depressed. Personal coping and resiliency factors often determine whether someone is going to able to overcome the odds and survive or become despondent and depressed, explains Dr Khan. Some of his patients belong to some of the richest families of Pakistan ─ "multi-billionaires who have everything and more".

"In almost all such cases there is imbalance ─ either genetic factors for depression may be very strong or they may be leading imbalanced lives ─ indulging in substance abuse or find themselves in destructive relationships ─ that may affect their self-worth and image leading them to become clinically depressed," he says.

*Names have been changed to protect identity.