Mu'awiya
28th July 2007, 05:13 PM
Understanding Depressive Illnesses – An Overview
Abu Eesa Niamatullah
Source - Authors Blog (http://alternativeentertainment.wordpress.com/2007/07/25/understanding-depressive-illnesses-%e2%80%93-an-overview/)
I promised to write a brief summary of my take on Depression and associated issues as per the way I respond to email and phone queries on the subject.
First of all, some of you may find it surprising but there are a number of Muslims who can’t get their heads around the fact that Muslims can actually get physically depressed or suffer from mental problems. Why is that? I don’t know, but maybe it has something to do with the big cultural taboo and also maybe the fact that people can’t understand why someone who has Allah and His Messenger could ever fall into depression in this Dunya.
So, from the onset, depression and mental illnesses are a real problem in our communities and there are various ways of dealing with them.
In Islam, we have a unique take on illness and disease states. We can divide illnesses into some broad categories which overlap and indicate the multitude of treatment options.
Diseases of the Heart
The first type of illness is the most deadly: the illness/diseases of the heart. When the heart becomes sick, and here we mean spiritually as opposed to a physical myocardial problem, then not only does the person’s religion come under severe threat, but indeed the rest of the body can physically suffer. How this happens is from the matters of the Ghayb – but it happens.
We know that the Prophet (sallallāhu alayhi wa sallam) warned us that if the heart becomes corrupt, then the entire body will become corrupt. This is the physical. He (sallallāhu alayhi wa sallam) informed us that the heart is the source of taqwa, our key to Paradise. This is the spiritual. Ibrahīm (‘alayhis-salām) informs us in the Qur’ān that entry to Paradise will be based on a sound and good heart. Thus, the health and condition of the heart is absolutely vital; keeping it alive by remembering Allah through dhikr and good deeds, and protecting it from the evils of disobeying Allah as well as envy, lying, jealousy, greed, lust and so on.
Thus thereby the treatment for the sick heart becomes known – to keep it high in imān and protect it from dying with sin and kufr. Its doctors are the ‘Ulemā – and that’s why the greatest profession one can enter is to be in the service of God by saving peoples’ lives – their real life, which is their state of Islam.
Physical Illnesses
The second type of illness are those physical conditions such as cardiovascular problems, joint pain, gastro-intestinal disorder etc. These express in a variety of different ways, some which we are finding out more about day by day as we advance further into this field.
They have a variety of causes, some which have been alluded to into the Sunnah and others which we have discovered through technology. The Prophet (sallallāhu alayhi wa sallam) indicated the problem of genetic mutation and also the fact that many conditions are down to our own selves, usually via indulgence and greed. In an interesting yet weak narration, it is said that the Prophet (sallallāhu alayhi wa sallam) was gifted a personal Physician by the ruler Qawqas which was refused by his statement, “We have no need for a Doctor. We don’t eat that much.”
Indeed, it becomes clearer every day that the way we personally deal with our bodies with respect to diet, exercise and the ingestion of various poisons that we have created such as alcohol, drugs, smoke and pollution is proving to be the main cause of our various disease and mental conditions that we suffer from.
The third main cause is clear from the Qur’ān and the Sunnah, particular with the example of Prophet Ayyūb (‘alayhis-salām) who was afflicted with a condition that was neither genetic or self-inflicted but rather a test from His Creator in order to raise his status – this no doubt exists in the world today with Allah ‘azza wa jall testing thousands of people with conditions that they have no control over in its inception but they are being given more control over with respect to the consequence, whether in this world or in the next; for indeed, there has not been sent down a disease except that a cure is available for it.
The treatment of all these conditions are mainly in the hands of conventional doctors – they will use “conventional” medication in the form of drugs and techniques to cure and alleviate much of what has been mentioned, and this very much includes certain complicated medication to deal with mental illness and clinical depression too, often with excellent results.
Here though, we have the first cross-over, for the “traditional” doctors (for the sake of argument), have also shown great benefit. Here, “traditional” refers to using other than complicated manufactured medication but rather the use of cupping, cauterisation, herbs, “alternative” medicines etc.
Likewise, the same group or others will also use ruqyah – a “faith healing” of sorts – that uses the Qur’ān and Prophetic invocations to cure people of even conventional physical problems such as arthritis or heart problems. The trained Rāqī (authentic faith healer) will be the expert here deciding what is possible and what isn’t. The Sunnah is replete of examples of this, and even today, we as Muslim health professionals will always utilise these methods with varying success rates, similar or maybe less than those with “conventional” treatment.
Also, direct du‘ā to Allah must never be forgotten as often is during treatment plans. Allah ‘azza wa jall is the One who sends down and He is the One who can remove – He is not tied to convention or rules as we understand them, and His Power transcends our limited minds and perceived logic.
Hence we see in this second group of illness the large cross-over of treatment plans and Practioners involved.
“Extra-Ordinary” Illnesses
The last type of illness generally speaking can be seen as the extra-ordinary kind; these include being afflicted by the “Evil Eye”, by black magic and indeed possession by Jinn.
These states are treated by a Rāqī who is knowledgeable of the field, often by experience more than formal tutoring, and who will be signified by his piety and knowledge as opposed to his results, “diagnosis” and fame as the many Charlatans, “Pīrs” and “Faith Healers” are known by today.
Treatment will involve the use of the Qur’ān and those medications made up by the experienced and trusted ones as opposed to the often kufr and shirk of the amulets and trinkets of the Charlatans.
This is a brief and very general overview of illness as we understand it.
Diagnosis and Treatment
As for the specifics of being approached by someone who is suffering from depression or a mental condition that has such varying symptons that makes one confused to whether magic or Jinn could be involved, then I utilise a basic system of diagnosis.
Diagnosis must always start with the obvious: many Muslims must start to recognise that the Sunnah when implemented in full acts as a protection against much of what we may call mental issues. The Sunnah here refers to the obligation of seeking knowledge and the use of supplication to protect against external forces.
For example, the Shaytān and his fellow Jinn (as a species) supporters love to whisper and suggest to the weak one who doesn’t know better. Here, ‘ilm is a must as not only will you recognise your enemy and be prepared for him, but you can physically repel him such as by using the Ayat’l-Kursi upon sleeping as in the famous narration.
Likewise, studying divine knowledge gives you power to understand scenarios which otherwise might lead to the problem of waswasa (”whispering doubts”) – such as the fact that certainty can never be overcome by doubt – and other relevant legal maxims.
Likewise, having knowledge ensures that you don’t injure others by afflicting them with the Eye – saying “Māsha’Allāh Tabārakallāh” when you see or hear of a blessing that your brother or sister has been gifted with will protect all and sundry and indeed increase the blessing.
Probably the most important aspect of this though is that obligatory knowledge of ‘aqīdah that instills an understanding of Qadr – the Divine Decree – which invariably adds perspective and understanding to an otherwise difficult and confusing situation. Armed with this, one can understand when one is being put through trial and tribulation for a greater reward in the Next Life, or indeed that certain things were meant to happen in such a way so that you realise immediately that you could do nothing more about it and hence not get stressed or “depressed” over it. Indeed, Allah says:
“Do not lose heart and do not grieve, and you are the upper-most if you are believers.”
(Ale-‘Imrān, 139)
As for the Sunnah in a general sense, then how can one expect to be protected from the Dunya and all its stresses when one is not keeping their heart content with the dhikr of Allah? How can one escape the stresses and pressures of the Dunya when there is nothing but the Dunya in the heart and mind? How many of those who claim to be suffering mental problems actually live a truly Islamic way of life in every sense possible?
So, to combine all the sciences of the Sunnah and to practise ones Islam fully and completely in all spheres of life as one should do – this is the primary solution and treatment in the vast majority of those people who come with a “depressive” condition.
The next thing we do as the Clinicians always remind us is to contextualise the problem – often, our deviance from “normality” is a false perception that does not stand up to scrutiny. One person’s depression is another person’s normal day. One person’s stress is another person’s challenge. One person’s “voices in the head” are another person’s Shaytan trying to get in where he possibly can.
If indeed there is a clear indication of illness though, then we will proceed to refer to the Physicians – and this is something that we do responsibly being fully aware of the trend amongst certain Doctors to go straight to serious medication when in fact a good consultation will prove just as valuable.
As is well known in Pharmacy, many a times a patient will leave a surgery with a prescription for anti-depressive medication for their “condition” only to have one look at the side-effect profile of their new pill and suddenly decide that they’re not that depressed after all. Naturally, the doctor will not be informed of this change of heart, as they will not be informed when the Pharmacy takes back complete packets of unused medication after Patients have successfully tried to deal with their circumstances themselves.
And difficulty dealing with personal circumstances is proving to be the single major cause of depressive cases presenting to GPs in our communities today from our own (mostly female) Muslims. Family pressures, in-law oppression, forced or arranged marriages, abusive husbands, language barriers, misplaced piety and a whole host of domestic fitnah – one is thankful that every depressive case isn’t a suicide case after we realise what our women are being forced to live through.
As usual then, we are proving to be our own worst enemies; our conditions will not change until we change the root causes behind them ourselves.
Finally, I might be presented with a person who is clearly exhibiting behaviour uncharacteristic of any of the above, and I will then either refer to a qualified psychiatrist or directly to one of the very few brothers that are experienced and trusted in the field of detecting black magic or Jinn possession. It will only take a few minutes for such an expert to determine whether the problem needs medical intervention or not, and this then ends the diagnostic procedure one undertakes when presented with people complaining of such problems.
I have taken great liberty in generalising much of this topic, and then adding a personal perspective from my own experiences. This is obviously not comprehensive but it has only been penned together quickly to add perspective to those who either believe they are suffering from such or know others that might need some basic advice.
And Allah knows best.
Abu Eesa Niamatullah
Source - Authors Blog (http://alternativeentertainment.wordpress.com/2007/07/25/understanding-depressive-illnesses-%e2%80%93-an-overview/)
I promised to write a brief summary of my take on Depression and associated issues as per the way I respond to email and phone queries on the subject.
First of all, some of you may find it surprising but there are a number of Muslims who can’t get their heads around the fact that Muslims can actually get physically depressed or suffer from mental problems. Why is that? I don’t know, but maybe it has something to do with the big cultural taboo and also maybe the fact that people can’t understand why someone who has Allah and His Messenger could ever fall into depression in this Dunya.
So, from the onset, depression and mental illnesses are a real problem in our communities and there are various ways of dealing with them.
In Islam, we have a unique take on illness and disease states. We can divide illnesses into some broad categories which overlap and indicate the multitude of treatment options.
Diseases of the Heart
The first type of illness is the most deadly: the illness/diseases of the heart. When the heart becomes sick, and here we mean spiritually as opposed to a physical myocardial problem, then not only does the person’s religion come under severe threat, but indeed the rest of the body can physically suffer. How this happens is from the matters of the Ghayb – but it happens.
We know that the Prophet (sallallāhu alayhi wa sallam) warned us that if the heart becomes corrupt, then the entire body will become corrupt. This is the physical. He (sallallāhu alayhi wa sallam) informed us that the heart is the source of taqwa, our key to Paradise. This is the spiritual. Ibrahīm (‘alayhis-salām) informs us in the Qur’ān that entry to Paradise will be based on a sound and good heart. Thus, the health and condition of the heart is absolutely vital; keeping it alive by remembering Allah through dhikr and good deeds, and protecting it from the evils of disobeying Allah as well as envy, lying, jealousy, greed, lust and so on.
Thus thereby the treatment for the sick heart becomes known – to keep it high in imān and protect it from dying with sin and kufr. Its doctors are the ‘Ulemā – and that’s why the greatest profession one can enter is to be in the service of God by saving peoples’ lives – their real life, which is their state of Islam.
Physical Illnesses
The second type of illness are those physical conditions such as cardiovascular problems, joint pain, gastro-intestinal disorder etc. These express in a variety of different ways, some which we are finding out more about day by day as we advance further into this field.
They have a variety of causes, some which have been alluded to into the Sunnah and others which we have discovered through technology. The Prophet (sallallāhu alayhi wa sallam) indicated the problem of genetic mutation and also the fact that many conditions are down to our own selves, usually via indulgence and greed. In an interesting yet weak narration, it is said that the Prophet (sallallāhu alayhi wa sallam) was gifted a personal Physician by the ruler Qawqas which was refused by his statement, “We have no need for a Doctor. We don’t eat that much.”
Indeed, it becomes clearer every day that the way we personally deal with our bodies with respect to diet, exercise and the ingestion of various poisons that we have created such as alcohol, drugs, smoke and pollution is proving to be the main cause of our various disease and mental conditions that we suffer from.
The third main cause is clear from the Qur’ān and the Sunnah, particular with the example of Prophet Ayyūb (‘alayhis-salām) who was afflicted with a condition that was neither genetic or self-inflicted but rather a test from His Creator in order to raise his status – this no doubt exists in the world today with Allah ‘azza wa jall testing thousands of people with conditions that they have no control over in its inception but they are being given more control over with respect to the consequence, whether in this world or in the next; for indeed, there has not been sent down a disease except that a cure is available for it.
The treatment of all these conditions are mainly in the hands of conventional doctors – they will use “conventional” medication in the form of drugs and techniques to cure and alleviate much of what has been mentioned, and this very much includes certain complicated medication to deal with mental illness and clinical depression too, often with excellent results.
Here though, we have the first cross-over, for the “traditional” doctors (for the sake of argument), have also shown great benefit. Here, “traditional” refers to using other than complicated manufactured medication but rather the use of cupping, cauterisation, herbs, “alternative” medicines etc.
Likewise, the same group or others will also use ruqyah – a “faith healing” of sorts – that uses the Qur’ān and Prophetic invocations to cure people of even conventional physical problems such as arthritis or heart problems. The trained Rāqī (authentic faith healer) will be the expert here deciding what is possible and what isn’t. The Sunnah is replete of examples of this, and even today, we as Muslim health professionals will always utilise these methods with varying success rates, similar or maybe less than those with “conventional” treatment.
Also, direct du‘ā to Allah must never be forgotten as often is during treatment plans. Allah ‘azza wa jall is the One who sends down and He is the One who can remove – He is not tied to convention or rules as we understand them, and His Power transcends our limited minds and perceived logic.
Hence we see in this second group of illness the large cross-over of treatment plans and Practioners involved.
“Extra-Ordinary” Illnesses
The last type of illness generally speaking can be seen as the extra-ordinary kind; these include being afflicted by the “Evil Eye”, by black magic and indeed possession by Jinn.
These states are treated by a Rāqī who is knowledgeable of the field, often by experience more than formal tutoring, and who will be signified by his piety and knowledge as opposed to his results, “diagnosis” and fame as the many Charlatans, “Pīrs” and “Faith Healers” are known by today.
Treatment will involve the use of the Qur’ān and those medications made up by the experienced and trusted ones as opposed to the often kufr and shirk of the amulets and trinkets of the Charlatans.
This is a brief and very general overview of illness as we understand it.
Diagnosis and Treatment
As for the specifics of being approached by someone who is suffering from depression or a mental condition that has such varying symptons that makes one confused to whether magic or Jinn could be involved, then I utilise a basic system of diagnosis.
Diagnosis must always start with the obvious: many Muslims must start to recognise that the Sunnah when implemented in full acts as a protection against much of what we may call mental issues. The Sunnah here refers to the obligation of seeking knowledge and the use of supplication to protect against external forces.
For example, the Shaytān and his fellow Jinn (as a species) supporters love to whisper and suggest to the weak one who doesn’t know better. Here, ‘ilm is a must as not only will you recognise your enemy and be prepared for him, but you can physically repel him such as by using the Ayat’l-Kursi upon sleeping as in the famous narration.
Likewise, studying divine knowledge gives you power to understand scenarios which otherwise might lead to the problem of waswasa (”whispering doubts”) – such as the fact that certainty can never be overcome by doubt – and other relevant legal maxims.
Likewise, having knowledge ensures that you don’t injure others by afflicting them with the Eye – saying “Māsha’Allāh Tabārakallāh” when you see or hear of a blessing that your brother or sister has been gifted with will protect all and sundry and indeed increase the blessing.
Probably the most important aspect of this though is that obligatory knowledge of ‘aqīdah that instills an understanding of Qadr – the Divine Decree – which invariably adds perspective and understanding to an otherwise difficult and confusing situation. Armed with this, one can understand when one is being put through trial and tribulation for a greater reward in the Next Life, or indeed that certain things were meant to happen in such a way so that you realise immediately that you could do nothing more about it and hence not get stressed or “depressed” over it. Indeed, Allah says:
“Do not lose heart and do not grieve, and you are the upper-most if you are believers.”
(Ale-‘Imrān, 139)
As for the Sunnah in a general sense, then how can one expect to be protected from the Dunya and all its stresses when one is not keeping their heart content with the dhikr of Allah? How can one escape the stresses and pressures of the Dunya when there is nothing but the Dunya in the heart and mind? How many of those who claim to be suffering mental problems actually live a truly Islamic way of life in every sense possible?
So, to combine all the sciences of the Sunnah and to practise ones Islam fully and completely in all spheres of life as one should do – this is the primary solution and treatment in the vast majority of those people who come with a “depressive” condition.
The next thing we do as the Clinicians always remind us is to contextualise the problem – often, our deviance from “normality” is a false perception that does not stand up to scrutiny. One person’s depression is another person’s normal day. One person’s stress is another person’s challenge. One person’s “voices in the head” are another person’s Shaytan trying to get in where he possibly can.
If indeed there is a clear indication of illness though, then we will proceed to refer to the Physicians – and this is something that we do responsibly being fully aware of the trend amongst certain Doctors to go straight to serious medication when in fact a good consultation will prove just as valuable.
As is well known in Pharmacy, many a times a patient will leave a surgery with a prescription for anti-depressive medication for their “condition” only to have one look at the side-effect profile of their new pill and suddenly decide that they’re not that depressed after all. Naturally, the doctor will not be informed of this change of heart, as they will not be informed when the Pharmacy takes back complete packets of unused medication after Patients have successfully tried to deal with their circumstances themselves.
And difficulty dealing with personal circumstances is proving to be the single major cause of depressive cases presenting to GPs in our communities today from our own (mostly female) Muslims. Family pressures, in-law oppression, forced or arranged marriages, abusive husbands, language barriers, misplaced piety and a whole host of domestic fitnah – one is thankful that every depressive case isn’t a suicide case after we realise what our women are being forced to live through.
As usual then, we are proving to be our own worst enemies; our conditions will not change until we change the root causes behind them ourselves.
Finally, I might be presented with a person who is clearly exhibiting behaviour uncharacteristic of any of the above, and I will then either refer to a qualified psychiatrist or directly to one of the very few brothers that are experienced and trusted in the field of detecting black magic or Jinn possession. It will only take a few minutes for such an expert to determine whether the problem needs medical intervention or not, and this then ends the diagnostic procedure one undertakes when presented with people complaining of such problems.
I have taken great liberty in generalising much of this topic, and then adding a personal perspective from my own experiences. This is obviously not comprehensive but it has only been penned together quickly to add perspective to those who either believe they are suffering from such or know others that might need some basic advice.
And Allah knows best.