An Islamic Perspective on Depression

Muslim organizations are involved in developing mosque-based mental health networks

BY BASHEER AHMED

Depression is a common mental disorder from which an estimated 5% of the world’s adult population suffers. Yet, despite the growth of this country’s Muslim population, no reliable data indicates how many of them suffer from depression. Mental health statistics are generally difficult to track due to underreporting, stigma and the varying definitions of mental illness.

The U.S. government’s post-9/11 response has caused Muslims psychological distress. Farhana Khera wrote that according to one former senior FBI counterterrorism official, the FBI conducted nearly 500,000 interviews of Muslim and Arab men from 2001-05 (CNN, Oct. 26, 2011). Nationwide, mosques have been checked for, among things, nuclear devices, and tens of thousands have been detained or deported. In the Greater Detroit area, 25% of Arab adults reported enduring abuse after 9/11 (Asim Padela, M.D. and Michele Heisler, M.D., American Journal of Public Health, Dec. 17, 2009).

A Yale University study conducted by Dr. Mona Amer noted that 50% of all ArabAmericans surveyed had clinical signs of depression. Muslim youth aged 18 to 28 are the least happy and the angriest compared to non-Muslim youth (Soc. Psychiatry Psychatiar, 2012, 47:409-18).

Almost everybody experiences depression, a general term used for a negative emotional experience (e.g., the loss of loved ones, income, property, divorce and personal trauma). Usually, these episodes last for a few weeks to several months and, in due course, are overcome.

Sometimes, if there are no discernable underlying causes or only minimum precipitating factors, this depression lasts longer and creates disturbances in the family. They cannot hide its symptoms — a loss of interest in work, studies, and relationships, irritability, difficulty in making decisions, extreme difficulty coping with minor stresses and showing severe guilt and self-blame. There are also physical symptoms, such as a lack of energy, poor concentration and loss of sleep, appetite and weight. Some may feel suicidal but keep their feelings to themselves.

Usually, family members or coworkers recognize what’s going on, although most sufferers remain in denial. If the symptoms are visible, then they must be convinced to seek help. It’s difficult for family and friends to do this. Asking someone about suicide won’t put the idea into his/her head. In fact, such people often feel relieved when someone asks.

A common feeling among the depressed is that their lives don’t matter and no one would care if they were gone. The longer the treatment is delayed, the longer it takes to get better. I have seen people lose their job and even their family members (separation and divorce), which may lead to even more severe consequences.

Causes. It’s more common in individuals with close relatives who have experienced depression. Deficiency of neurotransmitters, such as norepinephrine and serotonin, may also cause it. While this mental illness appears to have biological components, psychological and social factors also play a vital role. Treatments. Friends and family may be of help in mild cases. Having someone who is willing to listen and ask serious questions can make all the difference.

Some moderate and most severe cases respond to antidepressant medications and counselors who can provide practical advice and emotional care. Cognitive behavior therapy (CBT) helps a person respond to challenges more positively. In cases of severe depression, electro-conversion therapy has been proven to be beneficial. ih

Incorporate Religion And Spirituality

Islam provides behavioral codes and values that give its adherents’ life meaning and purpose. As a strong faith gives people hope, survival skills and ways to deal with stressful events, we must somehow incorporate Islamic values and ethics into psychotherapy. This approach reinforces one’s sense of belonging, provides one with a larger support group when confronting despair and loneliness, and helps one deal with stress and depression. The strength of spiritual feelings also gives a sense of divine support, self-respect and self-confidence.

Many psychiatrists and psychotherapists in the West discourage the use of religious concepts to treat emotional disorders. As a result, many Muslims are reluctant to seek help from non-Muslim therapists due to cultural, religious and language issues, and their concern that these professionals may not understand the dynamics and stresses they are experiencing. Muslims hesitate to seek mental health services if they fear that their religious identity might be threatened. For example, a hijabi doesn’t want to hear, “You just need to take off your hijab and assimilate.”

During a traumatic event or difficult times, Muslims often contact imams. Unfortunately, many of them are unaware of the available resources due to their being born abroad and struggling with their new language and culture. Thus, most of them can only address the issues related to stress and depression. Although most of them have no formal training in counseling intervention and therefore offer unstructured counseling based on Islamic knowledge, they are often the first responders for those experiencing psychological trauma and depression.

Imams also have difficulty differentiating between the symptoms of various mental illnesses and lack familiarity with guidelines for psychological triage, which prevent them from referring to the appropriate agencies. Fortunately, many imams are eager to acquire such knowledge and training in crisis counseling.

Those afflicted may first contact imams with primary complaints of physical symptoms and family issues to avoid being stigmatized. Therefore, imams must be trained to ask questions that can reveal any underlying depression and/or anxiety, as well as suicidal feelings (https://psycnet.apa.org/ record/2012-19690-004).

In the last two decades, I have seen steady progress in Muslim organizations and mosques offering mental health services — most probably in Texas. MCC for Human Services, which I founded in 1995, was the first Muslim organization to provide medical and mental health services to indigent Muslims. Over the last 25 years, two or three Dallas-area clinics affiliated with Islamic centers have been active in this regard.

Post-9/11, the U.S. has seen a substantial increase in healthcare professionals specializing in treating mental problems. There is a growing awareness among Muslim religious leaders and imams that many Muslims in their congregation were approaching them with mental problems, especially depression. Imams began turning to mental health professionals for help. licensed therapists at mosques and community centers. The Khalil Center, established in 2017 in Chicago, offers faith-based mental health services to alleviate psychological distress and dysfunction. Its staff has adapted mainstream psychological interventions to an Islamic framework. It now has offices in California and New York. ICNA provides mental health services through ACCESS Mental Health & Family Counseling in Dearborn, Mich., and Muslim Family Services in Detroit.

As a first step, they set up sessions to familiarize imams with various mental health problems afflicting Muslims. There has also been some recognition of the need to incorporate faith and spirituality in treatment programs. Doing so both help improve the current condition and prevents subsequent episodes of depression.

Some mosques have even set up a 24-hour mental health hotline, which has been extremely helpful.

EDUCATING, TRAINING AND MENTAL HEALTH SERVICES

Mental health first aid training program for imams. This is the most widely used program in the U.S. The initial focus was on training them to identify symptoms of various mental disorders, making a basic assessment, and then deciding which people to refer to a specialist. Imams are trained to recognize stress-related disorders and counsel people to build coping mechanisms based on Islam, strengthening their faith, and receiving help when necessary.

They go through a comprehensive program to learn about mental illness, crisis intervention techniques, faith-based supportive therapy, and referring patients with serious depression.

Imams play an integral role, for Muslim Americans may be more willing to seek help from religious leaders.

Other organizations have become involved, among them SEEMA (Support Embrace Empower Mental Health Advocacy), which offers counseling for emotional problems. Officially launched in January 2018, it now has chapters in Chicago and Atlanta that host support groups with

Unfortunately, some of the curable mental health cases go undetected because of certain well-known misconceptions: People with true mental health issues are violent and that such disorders are signs of weakness and personality flaws. If depression goes undetected, the consequences can reach all the way to suicide.

Although significant progress has been made in the last 20 years, it is not enough. Many of those afflicted remain unidentified or have no access to treatment. Too many Muslims are committing suicide.

We need to increase the number of community mental health awareness campaigns that focus on recognizing mental health issues and why doing so is important. Emphasis should be placed on seeking professional help for problems like stress and depression. Muslim schools (weekend schools too) must engage professional counselors to train teachers to recognize the signs of mental health challenges in their students. ih