People carry a private idea of what bad enough looks like. Usually it’s crying in the car park at work, or a manager starting a sentence with “we’ve noticed.”
Short of that, someone who has slept badly since June and wakes at 4 to rehearse a meeting six hours away, who still goes in and still sends a thumbs up under every photo in the family group, will usually decide they’re tired. And tired doesn’t seem like something you book a psychologist for.
The line is probably in the wrong place.
Half of all people develop a mental health condition by the age of 75, according to a study of more than 150,000 adults in 29 countries. The single most common age for it to start is 15, roughly Grade 10. (The Lancet Psychiatry, 2023)
At The American Wellness Center in Dubai Healthcare City, our Psychology Department sees a lot of people in the months before it gets that far, still working, unsure they count.
Where it Shows up First
Sleep usually goes before anything else. In ResMed’s 2026 survey of 30,000 people across 13 countries, 53% said they sleep well 4 nights a week or fewer. Stress and anxiety were what kept 42% of the women and 36% of the men awake. (ResMed Global Sleep Survey, 2026)
Appetite follows, in either direction. Lunch turns into whatever’s in the desk drawer, or into nothing, and one afternoon coffee becomes two.
A Mass General Brigham study followed 85,551 people for a little over three years. Those with both depression and anxiety had about a 32% higher risk of heart attack, heart failure or stroke than people with only one of the two. (Circulation: Cardiovascular Imaging, December 2025)
The researchers linked it to stress activity in the brain and to inflammation.
Dr. Muhammad S. Tahir, Consultant Psychiatrist and Neurologist at AWC, drew the line between an ordinary low patch and something longer:
“Sadness is a momentary feeling. It is usually short lived, and you carry on with your work and your life. Depression is two weeks of continuous low mood, when your sleep and appetite are disturbed, your performance declines and your relationships are affected. Then you must seek help at the earliest, because waiting can lead to complications.”
Two weeks isn’t long. Whoever ends up crying in the car park has usually been past it for months.
At Home and at Work
The people closest to you get the worst of it, mostly because they’re the ones you stop making an effort with.
The World Health Organization counts 1 in 6 people worldwide as lonely, and lonely people are twice as likely to become depressed. (WHO, June 2025)
A move, a divorce or a close friend relocating can take more out of a person than they expect. Grief, loss and adjustment counselling is built for those changes as much as for bereavement.
You read the same email four times before sending it, and nobody in the office would guess.
Depression and anxiety cost the world around 12 billion working days a year, roughly US$1 trillion in lost productivity. (WHO, September 2026) In ResMed’s survey, 70% had called in sick at least once after a bad night. (ResMed, 2026)
What Early Looks Like
Australia’s national mental health survey found people waited 12 years on average between their first symptoms and first asking anyone for help. For anxiety it was 11 years, and for social anxiety 13. (University of Sydney, February 2025)
A lot of that delay is probably people comparing. A colleague has just lost her father, a friend is halfway through a divorce, and next to them a bad few months of sleep doesn’t feel like much to complain about.
If you’re always the last person you make room for, that’s a pattern in itself, and self-esteem and identity support works on it directly.
Early care is usually smaller than people picture:
- A handful of sessions about why your sleep went
- Learning what a panic attack is before the third one
- Talking through a move or a breakup while it’s still recent
- Checking whether it’s sadness or something that has lasted longer
If you’d rather not start with medication, non-medication therapy options are built for mild to moderate anxiety, low mood and stress.
Before it Gets Bad Enough
The person awake at 4 since June will probably still go in tomorrow and still send the thumbs up.
It might pass on its own. Sometimes it does, and nobody ever has to know there was a bad autumn.
But four months of bad sleep is reason enough to talk to someone without waiting for it to get worse.
The psychologists at The American Wellness Center in Dubai Healthcare City see a lot of people at this point, before the car park, when there’s still plenty to work with.
Book a first session whenever it suits you. Bring the four months, and whatever’s been keeping you up.
