Editor’s Letter: Mental Health

by Diana Rahim

It’s hard being a person. Nobody truly tells you this, nor are we really encouraged to look into this fact deeply. As a society, we are uncomfortable with confronting sadness and despair, and would rather concentrate on a superficial, easy-to-understand pursuit of happiness. We are taught to meet our basic material needs, to obsess over our educational and career paths, and to succeed in our society. Far less emphasis is placed on meeting our very important psychological and emotional needs, and in fostering the kind of habits that are emotionally healthy not just for us, but in our reactions to others as well. Very often, even basic emotional responses and sensitivity is stigmatized. Just think of common, dismissive phrases one often hears – “Don’t be so sensitive,” “You’re being oversensitive,” “Why can’t you take a joke?”

In truth, I truly believe that to see someone express emotion, sensitivity and vulnerability threatens the stability that some people have taken pains to sustain to cope with living in world that can be insensitive and indifferent.

In describing what I feel to be the deep undercurrent of despair that I think lies within so many of us, especially younger ones, I often mention the fact that every school I have been to has had a suicide. I say this because the epidemic of mental health crisis, depression, and unbearable anxiety, is rooted very much in the way modern (especially capitalist) societies are organized and how people are treated, and it is experienced as early as childhood in the schooling system.

It is there where we experience the pressure of group dynamics, the shame of classism, the neoliberal demand to succeed as individuals and to have our worth defined solely by our ability to be successfully productive. It is there where we learn that in order to feel respected and valued by those in authority, we have to live according to their rules no matter how painful, unnatural (or even unnecessary) such rules can be. And of course, some people are less aligned to the enforced standard than others, and such people are considered wayward and face more stresses.

I have to mention the fact of a person’s identity in relation to power because it is undeniably connected to the issue of mental health. While it is true that mental health issues affect people of any class, racial, or gender background, people from marginalized groups are disproportionately affected by mental health problems.

A recent study by the Institute of Mental Health (IMH) for example revealed that women in Singapore are more prone to depression than men, a pattern that is consistent in other countries (men however have higher rates of completed suicides). Women in the younger age group – between 18-34 years old — are more than twice as likely than men to suffer from major depressive disorder. Queer children (and certainly this very likely leads into adulthood) report staggeringly high rates of abuse and discrimination that in turn leads to mental health issues and even places them at high risk of suicide. There have been studies that also tracked Islamophobia to lead to long-term mental health issues (Islamophobia is also a gendered issue, with women who are visibly Muslim facing the brunt of hate crime attacks).

Behind these statistics lie real social causes and explanations. Gendered issues shore up when mental health professionals explain women’s higher rates of depression. Experiences of discrimination for LGBTQ+ youth also unsurprisingly figure into higher risks of suicide. The point is that alleviating the inequalities in our systems, and seriously working towards a society that is less discriminatory is not only an issue of justice, but of public health.

It also means that it is unwise to individualize someone’s mental health struggle as simply a personal problem or just an issue of chemical imbalance. It’s an easy cop-out of interrogating deeper, more systematic issues at play. Those who struggle are often victim-blamed for their own condition, being told that they are at fault for their own suffering. But a lot of times, this is simply not true.

One of the most moving pieces I’ve read recently on pursuing a more holistic approach to understanding mental health problems was by Johann Hari. I will share the following quote from his article “Is everything you think you know about depression wrong” on The Guardian, though the whole piece is worth reading in full (please do!):

“In its official statement for World Health Day in 2017, the United Nations reviewed the best evidence and concluded that “the dominant biomedical narrative of depression” is based on “biased and selective use of research outcomes” that “must be abandoned”. We need to move from “focusing on ‘chemical imbalances’”, they said, to focusing more on “power imbalances”.

After I learned all this, and what it means for us all, I started to long for the power to go back in time and speak to my teenage self on the day he was told a story about his depression that was going to send him off in the wrong direction for so many years. I wanted to tell him: “This pain you are feeling is not a pathology. It’s not crazy. It is a signal that your natural psychological needs are not being met. It is a form of grief – for yourself, and for the culture you live in going so wrong. I know how much it hurts. I know how deeply it cuts you. But you need to listen to this signal. We all need to listen to the people around us sending out this signal. It is telling you what is going wrong. It is telling you that you need to be connected in so many deep and stirring ways that you aren’t yet – but you can be, one day.”

If you are depressed and anxious, you are not a machine with malfunctioning parts. You are a human being with unmet needs. The only real way out of our epidemic of despair is for all of us, together, to begin to meet those human needs – for deep connection, to the things that really matter in life.”

People are often unkind or unable to better empathise with those who struggle with their mental health because they reductively view it as a personal affliction. But if we can see that the epidemic of suffering today is a natural psychological response, our brain’s way of telling us we can’t cope with such a world, then we could perhaps see that more can and should be done to make our society a more bearable and healthier place. One where discrimination is acknowledged and tackled. Where people won’t have to be driven to high levels of stress due to low wages. Where living a decent life is an affordable thing to have instead of considered a privilege. Where school systems are better refined to respect a child’s creativity and autonomy instead of stifling or resenting it. Personal worth has to not be tied to personal productivity, which in our times is leading to more mental distress and isolation.

It is not just stigma that has to be unlearned, but better responses to suffering that has to be learned. We need to actively learn how to respond when someone has an anxiety or panic attack. How to respond to someone who is depressed or who is having a psychotic episode. And just as importantly, we also need to learn how to take care of ourselves if we act as caregivers or support systems to loved ones.

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Those who struggle with their mental health almost always additionally suffer from the ignorance of those who shame it. And just as mental health struggles can stem from very specific experiences pertaining to our identities and the subsequent challenges it brings, the stigmas faced can be very specific too.

As Muslim women in this society, the conversation on mental health revolves around some big specific issues. In the submissions that will be published in this series, we can see how the language and framework of religion unfortunately can and has been used to invalidate or diminish a person’s suffering. There is often no theological basis to such dismissals (“you should pray more!” “Depression is shaitan”) but simply a more specific way to express the discomfort that people have when dealing with someone who is struggling with their mental health.

The common invalidating and shaming responses that a Muslim woman receives can often be cloaked in the garb of the faith. For this reason, we must pay attention to the language or behaviour that is often employed against those who suffer.

Perhaps it is because mental illness is an invisible affliction that reveals no bleeding wounds. A sickness that ails the mind. Perhaps its non-corporeal nature renders it susceptible to being invalidated through the lens of spirituality and religion. Historically, we do know that those who suffer from mental illness have even been thought to be possessed, spiritually afflicted, or beset by bad spirits.

Of course, it is unsurprising that for people who organise their lives around their faith, a religious explanation is sought after in explaining mental trauma. It’s not that the lens of religion and spirituality cannot be used at all in trying to figure out a way to deal with mental health struggles and trauma. In fact, there is some acknowledgement here perhaps that mental illness is something that requires more than just a medical explanation and solution (it has to include, as aforementioned, one’s own personal history and experiences).

The problem is that the tendency to simplistic and damaging methods or explanations (like possession) fail to truly and holistically understand the individual’s condition. The problem is that it can result in further trauma, impeding the person’s healing.

Perhaps mental illness can be seen in some way as a kind of spiritual affliction, but not the kind that denotes possession or being haunted by bad spirits. Psychotherapist Michael Cornwall describes the experience of going through madness as a ‘transformative journey’; an extreme emotional state that occurs often due to the immense stresses and despair of alienating modern existence.

Grief and confusion can be so profound that it destabilises us and cause great existential shifts that insists on being endured. The profoundness of these experiences are seen as ‘spiritual’ for some because it feels personally transformative. Such a reading would demand a solution that is far more acknowledging of this complex reality and addresses it, instead of simply thinking of the illness as a possession.

Understanding this, there could be a way that religion and spirituality can be specifically used to the benefit of someone who wants such an approach in their healing process. For example, Stefania Pandoifo provided a more informed way of including Islam into the understanding and treatment of patients. Through researching history and patients in Morocco, she shows how there is a space for the relevance of contemporary Islamic cures for madness.

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So many times, we know that to struggle with your mental health as a Muslim includes battling against accusations that you are spiritually weak, or that you have somehow invited this despair upon yourself through a lack of prayer, or a lack of faith. Of course this has no empirical basis, but such a conviction is not based on reason. It stems from a lack of understanding and ignorance about the reality of mental health issues and what living with it is like. To be depressed is not simply to be ‘very sad’ and to suffer from anxiety cannot simply be healed by surrendering to the will of God, especially since your anxiety can make it impossible to do that in the first place.

The Islamic faith is replete with stories of prophets and sahabahs struggling with great despair in their lives. There were no words to pathologise any (if any) of their conditions at the time, but we would never deign to call these revered figures weak-willed or lacking in faith as they mourned the loss of wives, friends, family, or as they went through great sorrow, great pain, and the horrors of war (how many of them probably suffered from PTSD!).

In fact the courage of our prophets in being able to overcome great sorrow and tribulations have always been an inspiring example to emulate.

Religion can be part of the healing or coping process when it comes to struggling with one’s mental health, or supporting someone who is. But perhaps we should look towards these stories that affirm and validate the reality and difficulty of suffering instead of using the same, tiring religiously-laced platitudes that shame and invalidate someone’s suffering.

Due to the exposure to so much damaging and invalidating attitudes, it is not uncommon for those who have suffered or who continue to suffer with mental health issues to have a difficult, even hostile, relationship with the faith. To be shuffled from one spiritual doctor to the next without your consent (this happened to a friend of mine) is a kind indirect violence that leaves you feeling powerless. To be consistently told that you are not pious enough by those around you when you were in need of love and validation can leave you insecure and coping with immense guilt.

Often times, the employment of religion in the shaming and invalidation of your experience can leave you associating the faith with the trauma of your condition. It is understandable if the religion then is associated with pain to you.

It is okay to have this difficult relationship, and you don’t have to feel guilty. The fact is, of course, it was employed wrongfully by people who prioritised judgement over truly understanding and giving you the care that you needed. Your piousness has no bearing over the reality of your mental illness. Unfortunately, unlike humans, mental illness does not discriminate amongst the religious or non-religious.

 It is not uncommon for you to have to completely re-evaluate your relationship with the faith during and after your journey with your mental health struggle. For some, their understanding and relationship of the faith deepened as it provided a support system that those around them failed to provide. For others, their relationship with the faith has been too damaged by the invalidation and pain that has been associated with it. None of this wrong. The only true thing is the reality of your experience.  

If you are struggling with your mental health, I want you to know that your suffering is real, that your feelings are real, and that I know you are trying your best to survive. You are not selfish or lazy. There is no shame in your struggle, and I hope that you are taking healthy steps to recovery. There is a place for you in this world, and you are capable of helping and providing love and understanding for others too. You are not alone, though it might feel like that so completely. We are often isolated enough in this world. Though it may be hard, identify those who care about you in affirming and healthy ways, and don’t be afraid to reach out.

May we take better care of each other, and may our good intentions, especially when laced with the language of religion, be full of love, not judgement.