Health professionals note that an ever-increasing number of expatriates is falling victims to what they dub as ‘Visa neurosis’ — an informal term that refers to the anxiety disorders and depression related to visa and job status.

And the lack of a social support system in the form of family bonds or close community circle that the residents were used to back home, compel many to turn to substance abuse or aggressive behaviour like in the case of Paul (not the real name), a postgraduate in personnel management from India.

Paul came to Abu Dhabi a few years back with high hopes of securing gainful employment. With the validity of his visit visa nearly expiring, he settled for the post of an office administrator drawing a meagre salary of Dh1,800, hoping to switch job at the next best opportunity. With his employer’s constant threats of stamping him out of the country coupled with futile attempts at convincing the management for granting him family status, the 30-year old lost his mental balance.

According to his friends who were living with him, Paul started exhibiting violent traits in his behaviour. “He was a very friendly and likeable chap. But later he would not go to work for silly reasons and would slip to long depressed moods or go berserk and break things. First we thought it is just his frustration of not being able to bring his newly wed wife along with him,” said Kurian also hailing from Paul’s native state of Kerala. But the timely move of his roommates in seeking a psychiatrist’s help saved Paul’s life as he was diagnosed with suicidal ideation. His erstwhile roommates told this reporter that Paul quit his job on the doctor’s advice after a month’s treatment and went back to India for good.

Dr K.K. Muralidharan, psychiatrist at Ahalia Hospital, said that anxiety disorders arise from difficult living or working conditions that people are subjected to. He noted that there are numerous cases of cardiac neurosis caused by insecurity and phobia that manifests itself in other forms like palpitation, sleep disorder, sweating and the like.

“When the fear and insecurity persist for a long period, later they take on a different colouring and surface as palpitation or sweating that on the other hand stimulates a cardiac neurosis,” said Dr Muralidharan pointing at the increasing incidents of cardiac attacks among the young population.

Underlining the spate of such incidents in the last few years, the psychiatrist elaborated that the most common problems seen among patients are anxiety disorders, panic disorders, obsessive-compulsive disorder or generalised disorders, depression and substance abuse. “While phobias and panic disorders outnumber the others in terms of prevalence rates, depression and substance abuse like alcohol consumption, excessive smoking and taking sleeping tablets are also common among expat population without exemption of any nationalities,” said Dr Muralidharan.

He also stressed that popping down a sleeping tablet to relax and thus beat stress is becoming an increasingly dangerous trend among many patients. “What is surprising is the psychological dependence on sleeping tablets has become more of a legalised panacea for every problem. There is no stigma of any sort attached to it and people are no more reluctant to ask for sleeping tablets from friends or room mates.”

Reflecting on the issue, Dr Padmaraju, psychiatrist at New Medical Centre, opined that the stress-induced panic attacks, phobias and anxiety disorders turn to suicidal ideation. “When people cannot express their feelings like anger, frustration or revenge, these suppressed feelings turn inwards and become deliberate self-harm.

Substantiating his point with an example, Dr Padmaraju said that one of his ex-patients, an Indian in his early 30s, who suffered serious sleep disorders was brought to him in a similar condition. “When I studied his case, the underlying factor was that the man could not ventilate his frustrations at work to anybody as he was living alone and had no friends. I could intervene with medicine and therapy at the right time, otherwise he had serious intentions of taking his life.

Toeing the same line was Dr Rajeev Gupta, Consultant Cardiologist who noted that apprehensions and fears of a possible lay off from job is characteristic of the expatriate mindset in the Gulf countries. According to him, incidents of cardiac arrests triggered by stress and heat exposure are getting common, especially among the labour class. When the question was thrown to some of the residents, the most voiced opinion was that constant uncertainties over changing labour rules triggers panic among employees.

“One day we read that anybody who switches job will have to serve a six month ban. The next day, the authorities will come up with a clarification that some categories are exempted from the rule only to refute it further by stating that ban exemption will be considered on individual cases,” complained Marwan, an engineer from Syria.

Marwan said he is still perplexed whether to leave his present job as rules regarding the lifting of six-month ban are not yet clear. Many others were quick to blame the spiralling cost of living expenses complimented with many other combination factors like arbitrary hikes in room rates and consumer goods in depriving them of a peaceful existence in the country.

“Until half a decade back, the saving grace of working in Gulf countries was a fat bank balance at the end of your tenure here. People held that financial security in the form of some hundred thousands stacked away as savings compensated for what you endure here, with loved ones back home. But now keeping apart a few dirhams is a distant dream for many as it is a hand to mouth existence for many middle class families and individuals,” noted long timers in the UAE like Abdul Latif and Ramachandran Nair. And they do it at a price; failing mental and physical fitness.