TRUTHFULLY, I AM terrified of what people might think if I talk about my struggles with my health. I wonder if people will reject me, if I will lose friends all because of the stigma that surrounds mental illness within Muslim communities. But I would feel disingenuous if I spoke about Muslim attitudes toward mental illness and did not mention my own battle. I would feel as if I were cheating my brothers and sisters who suffer along with me—if I didn’t share my struggle.
It was in the autumn of my fifth year. I was balancing my kindergarten academics with Girl Scout meetings and dance classes, all while trying to find time for therapy before dinner and an 8 o’clock bedtime.
I had spent the summer before my first year in school indoors. When I did go out to play with my siblings or the neighborhood kids, I was disinterested, lethargic, and spoke often about death—my own. I often became panicked—intensely and irrationally—if I was away from my mother for more than a few minutes.
In my therapist’s office, I drew pictures and talked about my family—my five brothers and sisters, my overloaded mother, and my stressed father. The diagnosis came in the form of major depressive disorder that I inherited from my father. And later, I was diagnosed with anxiety disorder.
I had the luxury of professional medical help from an early age. I learned how to cope with the fact that my mind works differently. I learned what works in balancing my imbalances. And after several years of treatment, for the first time in my life I didn’t want to sleep time away. I wanted to be alive. I finally was experiencing what life could be and I was not let down.
Then in the autumn of my 21st year, I converted to Islam. As I learned about my new religion and my îmân grew, I felt a peace and clarity about life and my place in it that I had never before experienced. I didn’t want to do anything but please Allah. I was experiencing the sweetness of faith for the first time and I was not disappointed.
It was at this intersection in my life that my treatment for mental health issues and my faith collided. As I became a part of my local Islamic community, befriending Muslims and attending lectures, it was made clear to me that mental health issues can be entirely cured with strength of faith. And that those who felt depressed or anxious only felt this way because of some defect in their îmân. Being new to Islam, I deferred to those who knew more than I did about Islam and all things dealing with faith.
I stopped all treatment for my depression and anxiety disorder, and focused my entire life on seeking knowledge, praying, fasting, and making duʿa’. After a short while, my mental illness reared its ugly head. I dropped out of school, I stopped attending the mosque and answering the phone. I closed my email account, slept eighteen plus hours a day, and wouldn’t leave my apartment for weeks at a time.
Lack of Faith?
Huda Alkhateeb, who also suffers from major depressive disorder, explains that she was confronted with the same road block as a Muslim. She says: “I heard the clear message from Muslims I admire that we should not need mental health treatments if we believe, pray, fast, etc. hard enough. If I [had] let myself listen, I would have felt like depression is a sign I am not a good enough believer.”
Unlike Huda, I did listen to those who claimed my illness was nothing more than a weakness in iman. But no matter how much prayer I offered, duʿa’ I made, or knowledge I acquired, my mental health only worsened. I felt ashamed. I tried to hide from the community that could have helped me through this difficult time. Despite these feelings of inadequacies, I wanted to live. So I resumed treatment.
As Allah says in the Quran:
And do not kill yourselves. Surely, Allah is Most merciful to you. [Sûrat Al-Nisâ’, 4:29]
As I healed and reintegrated into the community, I discovered that many Muslims were suffering from mental illness in silence as I had. I could see the signs in my brothers and sisters, and several confided in me about how they were suffering no matter how strong they felt their îmân was or how much worship they performed.
According to a study conducted by Dr. Mona Amer at Yale University, nearly 50% of Arab-Americans, a largely Muslim segment of the population, show signs of clinical depression. (Source: http://usatoday30.usatoday.com/news/nation/2006-08-09-muslim-american-cover_x.htm)
Asma Abdullah, who suffers from depression, anxiety disorder, and Post-traumatic Stress Disorder (PTSD), says that she found no support in her community even from the sisters she had thought of as friends. She explains: “The first friend in college [within the Muslim community] I confided in expressed indifference. She thought I was exaggerating the severity of my issues or maybe she just didn’t want to deal with it. Other friends either betrayed my trust or couldn’t deal with it and eventually the friendships faded […] I don’t interact with or see my community anymore.”
Feeling isolated from the community or blamed for health problems can exacerbate mental health issues. Huda says: “My faith is the most important aspect of my personal self-definition, and I needed examples of faithful people to look up to and learn how to deal with this illness.” She and many like her would benefit from help within their community, but there is a lack of awareness and misconceptions need to be overcome on a large scale.
Researchers have found that within Muslims communities there is a huge stigma surrounding Muslims with mental health problems which leads to isolation of sufferers from their community. According to the Journal of Muslim Mental Health:
In a […] study examining attitudes toward mental health issues among Pakistani families in the United Kingdom (Tabassum, Macaskill, & Ahmad, 2000), none of the participants reported that they would consider marriage with a person with mental illness, only half expressed a willingness to socialize with such a person, and less than a quarter reported they would consider a close relationship. (Source: http://quod.lib.umich.edu/j/jmmh/10381607.0007.102/–mental-health-stigma-in-the-muslim-community?rgn=main;view=fulltext)
More than feeling ostracized from their communities, Muslims who suffer mental illness often even feel silenced about their mental illness within their families. Within many Muslim families, “because of concerns with family social standing, many researchers report that disclosure of mental illness is considered ‘shameful,’” reported The Journal of Muslim Mental Health.
Asma says she felt devastated and frustrated at her parents’ response when trying to get their help. She says: “If I was depressed, [my mother] would sit me down and yell at me for being useless and then ground me for a few months. This happened multiple times before she found out I was getting treatment. My father never speaks about, even when my mother and I are discussing it in front of him.”
Huda feels that she must hide her illness from her in-laws. She explains: “[my husband’s] family has been a major religious influence on me. However, I have not discussed my battle with depression with his family because I know from explaining how my father died [he committed suicide after losing a long battle with depression] that they see more as a spiritual failing than a physical disease.”
Allah says in the Quran:
The believing men and believing women are allies of one another. They enjoin what is right and forbid what is wrong and establish prayer and give zakah and obey Allah and His Messenger. Those – Allah will have mercy upon them. Indeed, Allah is Exalted in Might and Wise. [Sûrat Al-Tawbah, 9:71]
Mental Illness as a Physical Condition
But we are failing the believing men and women who are suffering from mental illness when we refuse to even admit that they have a problem. How can we help each other if we are in denial that help is needed?!
Huda’s in-laws and Asma’s parents’ responses are typical from Muslims who do not understand mental illness. Aḥâdîth like the following are often quoted as proof that mental illness is one of solely spiritual locus. The Messenger of Allah said:
No Muslim is touched by any worry, or sadness, and says: O Allah, I am your bond-servant, son of your bonds-man, and son of your bonds-woman. My forelock is in Your Hands; Your judgment is continuously being carried out upon me; Your sentence upon me is just. I ask You with every name that is Yours, with which You have named Yourself, brought down in Your book, taught to one of Your creation, or have preferred for Yourself in the hidden knowledge with You: that You make the Quran the spring of my heart, and the light of my chest, and the dispelling of my sadness, and deportation of my concern except that Allah dispels his worry and replaces his sadness with relief. (Ibn Ḥibbân)
As Muslims, we know this is true for the worry and sadness spoken about in the ḥadîth because we believe in the authority of Prophet Muhammad. But serious mental illness is not the same thing as worry or sadness. We must understand the difference between sadness and stress that can be resolved spiritually and a serious mental illness.
One can compare the difference in the two to the difference in low blood sugar of an otherwise healthy person and that of a person with diabetes. Low blood sugar can occur from an outside stimulus; for example, if someone hasn’t eaten in a while, their blood sugar will drop.
However, diabetes is a chronic internal process where chemicals of the body are out of balance. Similarly sadness or even situational depression can be brought on by an outside stimulus, like a death in the family, divorce, or other difficult life events. While mental illness, just like diabetes, is a chronic, chemical imbalance.
According to the National Alliance on Mental Illness (NAMI), one in four adults experiences a mental health disorder in a given year. And the Muslim community is not immune. Nearly all Muslim religious leaders in America said they spend a lot of their time providing informal mental health counselling to their congregation. (Source: http://quod.lib.umich.edu/j/jmmh/10381607.0007.102/–mental-health-stigma-in-the-muslim-community?rgn=main;view=fulltext)
Many Muslims prefer to seek help within their religious communities, whether it is in asking advice from their imam, their family, and/or their Muslim brothers or sisters. “Significantly greater numbers of participants reported willingness to seek help from family members (21%) or a religious leader (19%) than from mental health professionals (11%),” according to a study cited in The Journal of Muslim Mental Health. And many of those suffering who do seek help within their faith community are being told the same thing: What they are experiencing is a lack of faith.
However, modern medical science tells us that mental illness has very specific physical causes. It is often linked to abnormal functioning of nerve cell pathways that connect parts of the brain. Eric Kandel, M.D., a Nobel Prize laureate and professor of brain science at Columbia University, says: “All mental processes are brain processes and therefore all disorders of mental functioning are biological diseases …The brain is an organ of the mind. Where else could [mental illness] be if not in the brain?”
Recent research and medical breakthroughs shows us just how physically based mental illnesses can be. Northwestern Medicine scientists have developed the first blood test to diagnose major depression in adults. The test measures levels of RNA (the molecules that carry messages from our DNA) blood markers.
Eva Redei, who developed the test and is a professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine said: “This clearly indicates that you can have a blood-based laboratory test for depression, providing a scientific diagnosis in the same way [that] someone is diagnosed with high blood pressure or high cholesterol […] this test brings mental health diagnosis into the 21st century and offers the first personalized medicine approach to people suffering from depression.” (Source: http://www.northwestern.edu/newscenter/stories/2014/09/first-blood-test-to-diagnose-depression-in-adults.html#sthash.CQDpxdRi.dpuf)
Treatment: Spiritual + Physical Health Care
Knowing that mental illness is a real and physical ailment that needs to be treated medically does not negate the spiritual aspect of healing. Medical treatment and spiritual growth are not mutually exclusive. Allah has created the world and every process in it. We must seek whatever means He makes available to us. Even medical professionals recommend routine, like the five daily prayers, to offer stability in the life of someone suffering from mental health issues.
Similarly, understanding that there is a higher power who is in control of the universe and everything in it can offer solace to someone who feels out of control. And acts of charity can play a big role in improving self-confidence and can help the sufferer feel connected with the community. NAMI recommends a combination of medication, diet, physical activity, talk therapy, and other forms of psychosocial support, like family and community involvement to help the brain function more efficiently. Our leaders, communities, and families can play a big role in helping to heal those suffering from mental illness.
Faith and medical health care do not have to be thought of as conflicting approaches to treatment, as is often thought to be in the case of mental illness in Muslim communities. Zain Hamdan, who suffers from chronic depression, generalized anxiety disorder, and PTSD, knows that taking a spiritual and medical approach toward good mental health is very effective. Zain says: “I have sought spiritual treatment in the form of converting to Islam, as its teachings align with how I want to live my life in terms of inner and external peace. I have also sought treatment through conventional methods of psychology and drug treatment.”
Zain admits he hasn’t always had this approach to treating his mental health issues. He explains: “I felt peace when I became Muslim. However, after several years, the same issues resurfaced. I realized that I hadn’t dealt with them by becoming Muslim. I had only swapped one method of containment for another … I do believe faith is important. And I am fully convinced that God can remove any burden from your path if He sees fit to do so. However, I also acknowledge mental disorders are medical issues that require qualified individuals for assessment and treatment.”
Adjusting Help within our Faith Communities
Because of the severity of mental illness and the religious component that is so fundamental in healing, better awareness within Muslim communities is desperately needed. We must look at a two-pronged approach to treating mental health issues, one that is given both a serious medical and a faith-based importance.
Muslim leaders must be prepared to offer counseling that includes referring the sufferer to seek professional medical attention. Our brothers and sister need to be taught to lend an ear or a shoulder for comfort when a fellow Muslim is suffering from mental illness—instead of chastisement. Our families need to disregard taboos about mental illness—not chastise sufferers in their family—and to educate themselves in ways to offer support to their suffering family members in their journey to good health.
As with any other illness, mental illness can be coped with on a spiritual level, but that is not the only answer. Allah has given us a means to cure every disease. The Prophet said:
Allah has sent down both the disease and the cure, and He has appointed a cure for every disease, so treat yourselves medically, but use nothing unlawful. (Abû Dâwûd)
We must not reject the means and the mercy that Allah has afforded us in all manners whether physical, emotional, or spiritual.