Various statistics report that one in four people suffer from a mental health problem, such as clinical depression. This means that 3 out of 4 people know someone who has a mental health problem, or are carers to someone who does. Clinical depression is a leading cause of death worldwide, ranking along with heart disease. The World Health Organisation (WHO) reports that it is the biggest cause of disability globally and a reason for one of the commonest direct causes of death – suicide. The Mental Health Foundation reports that last year nearly 6000 deaths in the UK were by suicide, whilst an even more alarming figure of 1 in 15 attempt to take their life by suicide. They further report that suicide is the leading cause of death in men aged 20-49 years in the UK.
This year the UK has appointed a minister for the prevention of suicide, alongside other strategies, launched in the lead up to the 10th of October, a day designated by WHO as being World Mental Health Day, a day which aims to educate about mental well-being and put an end to the stigmas that spread through so many cultures preventing many from seeking help or even recognising the difficulties a lot of people (sufferers and carers) endure. Once upon a time, Muslim thinkers were at the forefront in recognising diseases of the mind and heart, pioneering the first hospitals and therapies for the mentally unwell, in a time when others were imprisoning them and making them live in dire conditions. Nowadays, sadly, that legacy is being forgotten by many Muslims, many of whom fall into the traps of marginalising their fellow Muslim brothers and sisters (let alone the rest of society) who suffer with mental health difficulties. Why do some people, including some Muslims, consider committing suicide?
One of our members wanted to take this opportunity to share his experiences of depression. He believes many mental health issues are misunderstood and there is still too much stigma attached to them, creating barriers in people being able to speak up and seeking help. He had a lot of ideas about how to approach this, but struggled to put in to words his feelings. His efforts were also impeded by one of the issues he experiences that forms part of his depression, which is a lack of mental energy. This led him to say the following:
A societal ideology in which the outspoken minds are the only ones able to speak, the introverted and crushed minds cannot compete. The ideas of the outspoken get stronger and spread, whilst the thoughts of those physically and mentally unable to speak get lost.
We’re incredibly grateful to share this invaluable piece with you, especially when many people who experience mental health issues fear being misunderstood and fear being made to feel even more vulnerable than what they already feel. We hope this open and honest piece enables others to come forward and seek help, and that together we can continue to carry this dialogue further and break whatever barriers there may be. The following is what one of our members has shared about his experience.
I’ve come to realise that what’s called clinical depression is different to someone just saying they’re feeling low. I remember when I was first diagnosed, the psychiatrist said that some of the symptoms I had, like not being able to sleep, not enjoying a lot of things I was doing, constantly feeling tired and low, and not being able to do my job and things that needed to be done, were indicators that I wasn’t well, especially as I was like this for months. I couldn’t understand that, and I knew others around me wouldn’t buy it; that felt like giving an excuse to legitimise why I could be lazy. It didn’t make me feel better because I felt judged by other people who managed to get over low points in their life. I remember one person even said to me that he doesn’t get how someone can get so low to the point that they don’t get out of bed and even neglect important duties. That hurt me.
Then one day I started to realise that I wasn’t even managing to pray properly, and I would struggle to do many things I used to find easy, like dhikr, reading about Islam, attending beneficial gatherings, praying on time.
I realised that something in how I was feeling was putting up a huge barrier that I felt dwarfed by. The mountain in my way was no longer just interrupting my worldly life and social things but it was eating away my identity.
I knew then that the symptoms the professionals mentioned like ‘not finding many things enjoyable, not managing to do things I needed to do’ etc, were different than what ‘normal’ people might feel. It wasn’t about not being bothered and it wasn’t about being lazy. It hurt when others used to comment that I hardly do anything. I could see that it looked like I just chose not to do anything, but I didn’t know how to describe that it wasn’t as simple as that. I didn’t even know how to respond.
Various things have a certain significance to different people. For some it might be their work, but for me it was my religion. I thought, if I’m not even fulfilling my religious obligations then something is seriously wrong. I was ill; I felt that my heart was blackened but I didn’t know what caused it. When the non-Muslim professionals spoke to me about depression they would describe that it might take away the things important to a person, without them really knowing how it happened. It might be said it wasn’t like they chose to do it directly. I didn’t want to become like this. But I am like this; I don’t want to be though. I am still responsible for what I do. But for some reason when I want to go and do wudu’ and then pray, it doesn’t just feel like what others might experience, such as waking up on a cold morning, putting cold water to their face, fighting a bit of tiredness, before finally trying to pray.
Instead, it feels like all of that, plus it feels like I have to lift a duvet made of iron bars and lead, with one finger, just to get out of bed, then climb mount Everest in a blizzard to get to the water, and wait ages for the ice to melt in my hand, in order to extract water to do wudu’. This is what my depression feels like and how it affects me. Simple things for others are like mountainous tasks for me.
When I was well, I enjoyed this whole process, plus feeling the sweetness of wanting to pray. But then that endowment of enjoying things was being reduced and doing almost anything was an even greater effort; I used to feel so tired and it was like I couldn’t see light, even when it was shone in my face.
They say many people do not appreciate their bounties until they lose it. I didn’t appreciate my health when I was well; I realise that now when I don’t have it.
Things got really desperate and I felt I’d try medication, though even now I still don’t want to be taking anything. It wasn’t easy because I was getting a lot of horrible side effects and it took ages until I managed to persevere with the current one. I am still taking it because I have noticed a bit of difference with it. I don’t think before I would have been able to write this blog post for instance. I didn’t want medication because I thought it was going to mess up my mind and body. I guess I started taking it when I believed I was already so messed up. I wish I didn’t let myself get as messed up as I did before taking it though; maybe it would have helped me more sooner. But some of the other medications I tried made me worse or didn’t do anything that I noticed strongly. It reminds you doesn’t it, that medications don’t create cure and they don’t always do what you hope… and sometimes there is cure without medication. Whatever Allah eternally willed to be shall be, He is the only Creator of cures.
I also reflected that had it not been a mental health problem, but something like cancer or a heart attack, I probably would have not given so much deep thinking into whether I would take medication or not. So what does that tell you about how many of us view mental health issues?
There were a lot of reasons I didn’t initially go to see a therapist, although there is a lot of clinical evidence to show how helpful therapy can be. Some of the reasons behind my reluctance were: shame; I didn’t want to admit I couldn’t just pick myself up; maybe I would be laughed at; or maybe someone would judge me or the therapy and make me feel foolish. But more than that, I didn’t think I could find a therapist who would understand. If I wanted to talk about the evil eye or about waswas or what being well means to me as a Muslim, I thought I wouldn’t find someone like that in the UK. But I did then speak to a non-Muslim therapist, and later a Muslim one.
Although I can’t say I’ve really given therapy a chance, I have learnt a lot about it however. Even the non-Muslim therapists have a general idea about the nature of my depression. They classified my symptoms as depression after reducing the description of my symptoms into core concepts. My way of talking about it is through terms I know and my beliefs and practices. But I can see that even a secular person would give some meaning to their experiences; both of us get reduced to core symptoms that forms the common language amongst the professionals. The Muslim therapist did a lot more in the sense of understanding the meanings behind my experience. But at the end of the day, whether the therapist understood the deeper meanings or not, depression is depression, and the tools they both provided were almost identical in principle. Of course, the benefit from a Muslim is greater, but I think I was too quick in the past to judge that a non-Muslim would not be able to give me any tools to help me.
I spoke to a Shaykh who told me that mental illness and physical illness can both be caused by the evil eye, jinn or black magic but that this doesn’t mean physical medications and strategies can’t be used against them. He said that modern medicines are taken by people who get strokes and heart attacks, even though it is possible that the stroke or heart attack was the result of an evil eye. It made me think then, why would I not behave the same way in trying to cure a mental illness? The Shaykh said that mental illnesses, whatever the cause, whether neurotransmitters misfiring, stress, drugs, evil eye, jinn or magic, leave a physical trace. When the cause is removed, it doesn’t mean the illness is cured. He was trying to tell me that there is benefit in the mental health services, even in the West, so long as one doesn’t deviate from Islamic beliefs and practices.
I used to get asked about suicidal thoughts a lot and most of the time I used to get really angry. I do know why it gets asked; it is because so many people, including Muslims, drown in that path. I think here the knowledge I acquired really saved me. If I didn’t know that suicide was such an enormous sin, and more than that, if I didn’t know that committing suicide might result in an exponentially more horrendous torment in the Hereafter, I probably would have done it by now, however many times, until I actually died. I am not happy in this world, but I know that much worse could be in store for me and that scares me a lot. If I didn’t know that a Muslim, no matter how dire his state becomes, is obligated to have hope of mercy from God, I too would have lost myself. When depressed, for someone who doesn’t believe in the Hereafter, I can imagine how terrible the feelings of hopelessness could become – it might be asked why would such a person put effort in this life?
When I used to get thoughts, they were usually all those types of thoughts that I was not accountable for; knowing this reduced my sense of guilt, though I still felt I must have a lot of evil in me. A lot of professionals say that when a person has clinical depression their view on the world gets skewed; they wear filtered glasses where only sad emotions frame the surroundings. So for me, this means that I see evidence of how awful I am, how unlovable I can be and how much of a failure I repeatedly demonstrate that I am; I fail in so many tasks. When I’m trying to be objective though, I realise that sometimes I am interpreting things wrongly. Those glimmers of insight only come about because of what Islam teaches. Knowing that a Muslim must always have a balance between hope and fear is like the anchor that keeps me from sinking.
Those things did not make me suicidal. It is just when I felt I was losing myself, my identity and the enthusiasm with which I would try to increase my good deeds… in those moments I felt the devil was taking over… in those moments had I abandoned hope, I would have done it. But Allah Protected me from that disaster. I am scared though about what might happen; if I lose my identity completely, then I would lose my insight into reality.
I feel that I let a lot of people down. Most of them are so polite that they don’t say it, but occasionally the sharpness of their disappointment and maybe resentment bites hard because I’m already biting into myself as it is. I think some people around me are getting better at understanding it but deep down I still feel those people do not really know what it is like. Many people who are very close to me find it hard to cope with how I am. They feel helpless and sometimes this comes out as anger, which makes me feel worse. When I am almost dead to the world, just lying down, or trying to lose myself in a distraction, or when I get in a panic or just start crying – that is hard for them to see. I can imagine if someone I loved was like that, almost all the time, it must be so hard, so I think they feel sad too.
Some people try to give me advice and I feel they don’t understand at all. I don’t talk very much usually. It is not just about opening my mouth and speaking words. The words feel heavy and the weight of them shuts my mouth. I want to be able to talk to my family and let it all out, but usually when I try, I go blank. I feel lost.
Sometimes what helps me a huge amount is when I know that it is OK to be silent and I can still get a hug without saying I need one. That is special and the ones who do that to me truly have a beautiful resilience; doing good to someone like me who doesn’t even show much appreciation. That is a beautiful quality, and I hope I can be like that too.
I feel I can tell the difference now between feeling depressed as a ‘normal’ person and feeling depressed in an illness kind of way. I’m sure there are many people hiding out there who are unwell and they haven’t yet realised. I know about some people who say their families call them lazy and useless in almost everything and this is really hard to stomach. Most of the people nowadays do not understand what depression is; most of them think of depression as we say in general terms, rather than the technical mental health term.
Some people actually are just lazy or irresponsible, but some people have an actual disability. It’s like telling a person with two arms to drive a car and telling a person with no arms to drive a car. Most people would realise the one with no arms cannot drive, or if they somehow adapt, most people realise how much harder it was for them to manage this ‘simple’ task – because they can see it. Only with depression most of us cannot see what part has been amputated or lost, so most people cannot tell the difference between the efforts required by different people.
I feel very low about myself. But recently I’ve become hopeful that my efforts in achieving even something little will be a reason for getting reward in the Hereafter because I feel like I find it harder than many people. But then I don’t know for sure how it is for others, though I think I am one of the worst. I am reminded however of how the one coin in charity of that Companion overtook the many coins of another who gave in charity. So maybe, because of my situation, the little I can do, I can still aim to get lots of reward for it.
Some Muslims give examples of pious people and even Prophets who endured hardships, painful emotions and sadness, but I think this is wrongly compared to depression. Depression is a broken mental state and a creeping defragmentation of one’s intellectual and emotional faculties, it results in falling into a darkness where the light of insight eventually burns out. Depression can lead to distorted perceptions and reduce the drive to work, and in a very bad state it leads to neglecting one’s obligations and responsibilities, including something important like the prayer. Depression can take a person down a dark tunnel until eventually the devil notices it and puts distressing thoughts into your mind and the result becomes one big mess.
It does that by eating away at a person’s courage, resilience and heart. It takes away the ability to cope. It makes you disabled and paralysed.
Although the Prophets endured the greatest hardships, it is important to remember that they were not affected by what I have felt, they were not affected by depression, they did not lose their minds, nor the ability to obey God; they are protected from all this.
Others however can be overwhelmed and affected. From the different people I spoke to I noticed that there were many different types of depression, this is just my experience here. I realised that it isn’t to do with how severe the trials are though. So although the Prophets had the hardest trials, it did not make them clinically depressed, lying in bed all day. Sometimes extremes of emotions (admittedly the perception of extreme emotions is subjective) do strange things to most people, people other than Prophets.
I am still unwell. My psychiatrist, psychologist and others gave me lots of advice about what needs to be done to improve.
It’s hard when one of the tools required to carry out the advice i.e. the mind, is itself damaged though. It is like trying to fill a bucket that has a hole in it with water. I need to turn the tap on at full force so that the quantity of water is so much that the bucket fills before it empties. That full force comes from putting into practice as many of the recommended interventions as possible. It takes a lot of energy. When I can’t turn the tap more to increase the volume of water, I need to ask others to help me turn the tap.
Therapy, medication, exercise, getting a normal routine, increasing dhikr, forcing a smile by remembering that it is Sunnah to smile despite how I feel, sitting with good people… I try to do as much as I can. The more that floods in with the options of things to do, the more that bucket fills up, but I’m not there yet.
Trying to fix my mind is like having to re-learn things, as if I was a child learning to read and write. I can’t pick up the lengthy text books anymore. I can’t concentrate or digest the information easily; this is another symptom of depression. So I need to read basic things, then climb up slowly to more detailed things. The same was my experience with increasing performing dhikr. On days of increased motivation, I could recite a dhikr 3000 times or more and then suddenly I would collapse and go to zero. But when I started to do say 100 times a day, I could keep that going and after a while I felt incomplete without finishing that 100, then I step up to 200 and so on. It is slow, but it is a surer way for me. There were so many adhkar and ayat from al-Qur’an that were recommended to me to recite and indeed I do feel at peace when I succeed. Then that feeling of succeeding motivates me to try something else, and I can actually smile because I feel like smiling.
Please note: If you have been affected by any of the issues mentioned here, please do speak to loved ones or seek professional help.