Whether facing a deadly eight-year war or seemingly unending economic crises, Iranians have been exposed to more than their fair share of stress in the past few decades. A significant 23 percent of Iranians—around 20 million people—struggle with mental health while 12 percent of men and 16 percent of women suffer from depression, according to figures from the Ministry of Health.

A recent study of children and adults in Tehran by the Iranian Pediatric Association found that 80 percent of residents experience at least one major stressful event per year and 45 percent report feeling stress due to the present economic situation. Association director Dr. Ahmad Ali Noorbala told an audience at the University of Tehran, "The results of this study show that the incidence of mental disorders in our country is increasing. We live in a country where people sometimes experience unpleasant events and face a lot of stress daily. If they cannot control the stress, they may face psychological problems, which can manifest physical illnesses." Nonetheless, traditional mentalities and lackluster education mean that a cultural stigma persists around the issue of mental health.

In the absence of adequate government attention to the increasing risks to mental health, a private clinic in Tehran is employing an integrative method of therapy—never before offered in Iran—to help individuals better cope with stress. Having begun general studies in 2011 and having recently completed three years of clinical research, the Aramesh Multidisciplinary Pain Clinic publicly launched its neuropsychotherapy services on August 15.

Their treatment method is a meta-framework which takes into account the dynamic interplay between the mind, body, society, and environment. This framework formulates a holistic therapeutic practice informed by neuroscientific research. Outside of Iran, such treatments were first pioneered around a decade ago.

“In countries like Iran where stress is very acute, using knowledge that can teach us how to manage this stress can prove immensely influential on our daily performance,” Masoud Nosratabadi, a professor of clinical psychology at the University of Social Welfare & Rehabilitation Sciences and a supervisor of the clinic’s neuropsychotherapy department told Bourse & Bazaar.

In recent months, Nostrabadi and his colleagues have seen an increase in patients complaining about stress related to rising economic anxieties. Due to returning US sanctions, promised to be “the strongest in history,” Iran’s currency has collapsed and inflation has risen. Most experts foresee inflation to return to 20 percent, pushing up the price of many common goods. With their livelihoods threatened, some Iranians are considering emigration. But most will not be able to escape the pressures of life under sanctions in this way.

Stress caused by economic conditions has public health consequences. As Nostrabadi points out, the common denominator of many serious ailments, from heart disease and cancer to strokes and respiratory sicknesses, is stress and related emotional disorders. Evidence suggests that stress either acts as the generator of disorders and diseases or it exacerbates sickness and inhibits recovery.

Nostrabati and his team cannot control how much stress is imposed on their patients, but they aim to arm them with the tools to better manage stress. Unfortunately, many individuals are debilitated by stress and find themselves frozen in a state of inaction. “‘Freezing’ is the worst response and in my experience many Iranians go down this path when facing major stress,” Nosratabadi said.

The experts at Aramesh Clinic turned to neuropsychotherapy because previous methods failed to use comprehensive evaluations of patients and lacked integrative solutions rooted in the brain, behavior, and cognition. Old methods also ignored the uniqueness of each patient by offering general treatment guidelines.

When patients first arrive at Aramesh, they undergo a full evaluation consisting of four dimensions: mental health and stress control, cognitive performance, brain biomarkers, and personality traits. The clinicians employ brain performance improvement technology including but not limited to neurofeedback and biofeedback therapy.

In such a treatment protocol, the clinicians at Aramesh Clinic display measure brain activity using electroencephalography (EEG) monitors attached to the scalp. Heart rate monitors are also used. With brain activity and heart rate displayed to the patient on a computer screen, they are then asked to try to regulate the mind and body in order to play a simple game or to play a film. For example, reducing ones heart rate to a target level will unfreeze a game of Pacman. Through repeated practice, training is intended to give the individual a degree of control over their mental and physical state encouraging them to apply the same techniques for stress management in their daily life.

In addition, the clinic offers psychotherapy with a focus on devising therapeutic processes that are unique to each person based on the integrative profile of the patient. Nosratabadi adds, “Our process doesn’t include medication, but we’re not against patients taking medication because some of the patients really need it.”

Neuropsychotherapy services offered at the clinic pursue two general goals. They have the potential to improve the personal and professional performance of people with a wide variety of vocations from students to executives to athletes. They can also help reduce the severity of ailments like chronic anxiety, chronic migraines, irritable bowel syndrome and sleep problems rooted in stress.

The clinic also focuses on improving corporate performance by offering evaluation services that seek to find ignored talent in corporations and incentivize workers. According to Nosratabadi, they have already consulted for many private organizations and individuals, but have yet to work with the government sector.

By neglecting mental health, Iran's government is also ignoring a major issue that is hurting its already embattled economy. As Pouya Paknejad, head of neuropsychotherapy at Aramesh Clinic's explains, to encourage government action, many countries calculate the significant losses their economies suffer each year due to stress. But there are no such source of information in Iran. "This way of thinking hasn't yet been entrenched here in Iran where we would calculate a rial equivalent to measure the impact on the economy whenever we speak of mental health," he says.

As with all other issues, reforms to Iran's approach to stress management are arriving slowly and with great difficulty. The government must better cooperate with the private sector to tackle this challenge that so greatly impacts the economy and the everyday lives of Iranians around the country.

Photo Credit: Radiokafka, Aramesh Clinic