Muslim Mental Health 101
The terms mental health, stress, anxiety, depression, self-care and other similar terms are commonly heard these days. They casually come up in our discussions, or are discussed in our classes and social media. There has been a rise in people and organizations promoting “mental health awareness.” What exactly is mental health and mental illness, and how do we understand them within an Islamic context?
Question #1: What is Mental Health?
From an Islamic theological perspective, psycho-spiritual health is directly related to a human being’s ability to actualize their primordial spiritual purpose. All human beings are created to tread a path that will ultimately ensure their salvation in the afterlife and their ability to acquire God’s pleasure. Health is thus, from an Islamic theological perspective, indicated by an individual’s successful ability to remain on this path of worship. Hence any obstacles that obstruct their ability to tread this path is seen as detrimental to human functioning and worthy of attention. This includes psychological, physical or emotional struggles that get in the way of our ability to worship Allāh freely.
More specifically, a holistic perspective on psychological health must be multidimensional as it encompasses our overall health and well-being. This includes:
- Physical health: diet and exercise, regular checkups with doctors, and hygiene
- Mental health: Our thoughts. Are they positive, realistic, and functional? Are they helping us complete our day-to-day goals and tasks?
- Emotional health: Awareness of feelings–both positive and negative–and the ability to regulate them in a healthy manner
- Social/behavioral health: Our relationships and interactions with others are healthy and functional. The ability to accept and enjoy happiness, as well as recognize and resolve conflict
- Spiritual health: Our connection and relationship with Allah, dhikr (remembrance of Allāh), duā, as well as completing our mandatory obligations to Allah such as prayer and fasting.
When all of these areas are balanced and working in harmony, we can achieve optimal mental health. However, mental health is fluid. We need to regularly and constantly work on finding this balance. Achieving better states in our mental, spiritual, psychological health and maturity is a constant journey that we traverse all our lives.
Naturally, the balance we strive for will look different at different stages of our lives. For example, during finals week, your attention may be more focused on academics, and your social or physical activities may take a backseat. Or you might find yourself taking temporary social breaks to seek reclusion, refocus, and recalibrate. This is still considered balance–striving for optimal mental wellness is not a linear journey. If you find lasting behavioral or emotional patterns that are not balanced, however, you will need to check in and identify how to get back to working towards balance.
Question #2: What is Mental Illness?
When our mental health is negatively affected for a significant amount of time, a mental illness can develop. It is an illness of our mind that impacts all areas of our health: emotional, mental, physical, social, and spiritual. A few triggers for mental illness are:
- Experiencing trauma
- Significant life changes
- Family conflict and distress
- Life stressors and/or lack of support and resources
Mental illness ranges in severity and symptoms. It can be non-clinical distress that all of us experience from time to time, or it can reach the clinical threshold (particularly when your overall mental health is neglected for too long). Additionally, it can manifest itself differently in people based on support systems, personal history, personality, genetics, and other factors.
Some examples of mental illness are:
- Obsessive Compulsive Disorder/waswasa
- Personality Disorders
Question #3: What is the place of mental health in the Islamic context?
Psychological and spiritual health is a necessary lifelong process that has been extensively discussed in the Islamic intellectual heritage. Gaining awareness into one’s psychological and spiritual functioning is necessary in forming a meaningful relationship with Allāh and following the mandates of our religion. Our greatest asset to doing so is our own very selves–just as we strive to work on intellectual and academic development, psycho-spiritual development is all the more important for success in this world and the next. Sahl bin ʿAbdullāh, may God be pleased with him, once said: “If one knows his mind, one knows his state between him and his Lord.”
The importance of personal development and refinement of character is established by the Prophetic tradition, wherein he (peace & blessings be upon him) said “I was exclusively sent to perfect good character”(Adab al-Mufrad, Bukharī). Thus, Muslim scholars and spiritual practitioners have contributed an immense body of literature on psychospiritual and character development. This Islamic scholarly heritage is replete with positive practices that promote psycho-spiritual well-being. They are made up of the reformation of human thinking, behavior, and emotional expressions. An intentional focus on psychological and spiritual development facilitates the development of holistic health and well-being.
Abū Zayd al-Balkhī, a 9th century Muslim polymath, mentions in his work on “The Sustenance of the Soul,” that intentional psychospiritual practices nurture a resilience to mental illness & that this is necessary as a preventative measure for all peoples. He even places a greater emphasis on mental over physical health illustrating as human beings we are all prone to psychological distress and few of us will ever escape the stressors of life. Therefore, the absence of consciously developing psychological strength or the lack of seeking assistance after dysfunction has started, can lead to unnecessary significant suffering (Badri, 2008).
Question #4: How do we cope with psychological distress?
It can be difficult to identify when and how to seek help. People may cope with psychological distress on their own in various ways such as:
- Turning to prayer, worship, and Allāh
- Turning to loved ones for support
- Gaining awareness and Understanding of their intrapsychic struggles
- Changing routine, diet, or exercise.
Sometimes however, these lifestyle changes and psychoeducational information are not enough to cope with or heal from distress. There are many ways to seek help. Some of these ways are listed below.
Religious and spiritual values are imperative in decision making, relationship building, resolving moral and ethical dilemmas, and letting go of things not in our control. In fact, people rely on religious beliefs and values to cope when experiencing psychological distress. Studies have found:
- 90% of people surveyed, coped through prayer & turning to religion
- Many individuals with even medical illnesses seek out alternative forms of treatment that include prayer, exercise, rituals, and traditional healers
- Significant numbers of people report a desire for greater integration of religious/spiritual care in medical treatments
- 80% of those studied with mental illness use religious coping
As Muslims, our connection with Allāh and our religious values are integrated in our daily lives on some level or another. So, religious considerations and building a religious identity (your own relationship and connection with Allah) is needed in treatment considerations for mental illness. It is essential to neither downplay the role of religion and spirituality in mental health nor attribute mental illnesses exclusively to low faith and lack of religiosity.
One-on-one counseling or therapy provides a safe, confidential, and structured space to talk through and identify issues a person may be experiencing. For some, therapy may become a regular part of self-care. For others, a few months of therapy is found beneficial. Individual therapy can be sought before distress starts to feel overwhelming. One does not have to consider themselves “sick” for them to turn to the option of therapy. Therapy can be an opportunity for learning, self discovery, building insight, and more. A few examples are:
- Learning new skills and techniques to manage or heal from their distress
- Developing an in-depth understanding of themselves
- Creating and implementing new lifestyle changes that increase quality of life
- Identifying and resolving conflicts in their lives
Traditional Islamically Integrated Psychotherapy (TIIP):
Integrating religious beliefs, practices and considerations can make the healing and growth process of therapy even more beneficial and long-term. Data from research studies have supported the idea that spiritual and religious approaches to treatment have been effective in treating many psychosocial issues.
TIIP is a therapeutic framework that is an ever-evolving modality of psychological treatment coined by Khalil Center. It utilizes models of psychotherapy inspired by the Qur’an, Sunnah, and the traditions of the scholars–particularly in the spiritual sciences of taziyah al-nafs (to assist in the attainment of spiritual contentment), while also incorporating modern clinical interventions.
Abu Ḥāmid Al-Ghazāli writes about the importance of psychospiritual health and its relation to our connection with Allah. In his Iḥya ʿUlūm al-Din he writes, “When God wishes well for a servant, He gives him awareness of his own deficiencies” (pg. 256). From this statement, we learn that the beginning to a path of achieving psycho-spiritual health is self-awareness, (inkishāf). This is one of the core principles of TIIP: the therapist acts as a psychospiritual practitioner and guides an introspective self-discovery of the person’s emotional state to bring awareness to one’s cognitive, emotional, and behavioral tendencies. After the person develops self-awareness of their habits, TIIP practitioners facilitate holistic health by working on the different aspects of the mind towards creating a psycho-spiritual balance.
Medication, as prescribed by a psychiatrist, can help in managing symptoms of a mental illness. Medication can become necessary in instances when an individual may not respond to psychotherapy or the intensity of their symptoms are presenting as a significant barrier for psychotherapeutic interventions.
A comprehensive approach that integrates best practices across psychiatry and clinical psychology can be used to create a clinically beneficial treatment plan. In fact, Abu Zayd al-Balkhī highlights two of the most common types of mental illness, those that are predominantly due to biological factors in contrast to those that are mostly psychological in origin. Understanding this can help us recognize the importance of accurately diagnosing and treating someone struggling with mental illness.
Support groups are a great resource to meet and hear from other people who are experiencing similar struggles. A support group will have a therapist or a qualified facilitator and group members. Support groups can:
- Be a source of support for you while giving you the opportunity to provide support for other members
- Help you learn more about your mental illness or problems
- Teach you new skills and coping strategies to help manage and reduce your symptoms or struggles, based on other people’s real experiences
Crisis hotlines or helplines are an excellent “in the moment” support to use if someone feels overwhelmed or is in crisis mode. A call can be made to a hotline anonymously. Speaking to a stranger who has the training to help in a difficult situation can be beneficial. A person can feel safe to share their struggles and get immediate help if needed.
Attending workshops, seminars, halaqas, or
community gatherings where health and wellness are encouraged can be helpful in
getting more information, ecognizing
resources around you, becoming aware of your mental health needs, or finding
support from others. While these programs are not treatment for mental illness,
they can help us check in with ourselves and help us identify specific things
we may need to do to help achieve balance.
Lukoff, Lu & Turner, 1992
Post, Puchalski & Larson, 2000
(Anderson, Heywood-Everett, Siddiqi, Wright, Meredith, & McMillan, 2015; Hook, Worthington, Davis, Jennings, Gartner, & Hook, 2010; McCullough, 1999; Smith, Bartz, & Richards, 2007; Worthington, Hook, Davis, & McDaniel, 2011; Worthington, Kurusu, McCullough, & Sandage, 1996; Worthington & Sandage, 2001)
(Keshavarzi & Khan 2018)
(Keshavarzi & Khan 2018)