Depression - The Medical & Islamic Perspectives

ummtaalib · March 13, 2014

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ummtaalib · March 13, 2014

Introduction

"Depression has become synonymous with living in a society overrun with innumerable problems. It is an ailment which has unfortunately reached epidemic proportions. Hardly a day passes, without some person complaining about his failures or of the acute depression that he is suffering, due to various factors."

Shaykh Yunus Patel Raheemahullah

"Depression is one of the most contemporary and paramount issues present in the world today — Whether it is in the Muslim or the Non-Muslim World."

Shaykh Sulaiman Moola

According to WHO (World Health Organisation),

"Depression is a common mental disorder. Globally, more than 350 million people of all ages suffer from depression."

How many of us know someone who is depressed? By this I do not mean people using the phrase, "I'm depressed!" This is a common phrase used by one and all. In this case what they really mean is they are "fed up" with certain aspects of their lives. This type of "depression" does not linger on. Neither is it distressing or soul-destroying.

According to the Oxford dictionary, depression means “extreme dejection”, and dejection is described as sad, heavy hearted, downcast, in low spirits. Regardless of what the clinical definition of 'depression' is or whether or not a person is diagnosed by medical professionals as having depression, there is a very real sense of 'extreme dejection' that some people may feel, where they experience a feeling of being weighed down with misery and hopelessness.

In the words of ordinary people, like you and I, this is what depression feels like:

"My sleep, before so uninterrupted, begins to be broken up. I wake at 3:30 a.m. Then I begin to wake at 1:30, 3:30, 5:30. And the darkness! It is like a black cloud pervading my being...."

"Depression is being in a dark pit from where there is no escape..."

"I used to wake up every morning and wonder if there was any point in getting out of bed and starting the day I had ahead of me...."

"Once the anxiety took over and I lost control of my thoughts, my mind moved to a very dark place...."

"On countless occasions I struggled with daily life – it's as if someone had tied a brick around my heart, and was daring me to swim. The slow suffocation and strangulation of despair would descend upon me, like a parachute gracefully landing...."

Stories

Heart rending stories of people suffering from depression, lost in the darkness of fear, anxiety.....

Casey's Story

I had become depressed, was in a constant state of anxiety and no longer had the energy to pretend everything was OK. I was lost, confused and desperate for a way out, but felt unable to confide in any one.

Bringing Back Nicola

I would go to the shop and come outside and forget where I was and panic, I would panic in the supermarket if I forgot what I wanted, I started counting to eight over and over again and also started scratching my head violently and playing with my hands, I didn’t know who I was anymore, I was lost and full of despair.

Living with Depression

During one episode I spent three whole weeks lying in my bed awake, unable to do anything and too caught up in my own mind to care. When depression came it was as if life had stood still. I stopped caring about how I looked, simply throwing clothes on and often going a whole week without washing my hair. And I became reclusive, pushing friends and family away so it was just me and my mind left.

A Student's Story

Once the anxiety took over and I lost control of my thoughts, my mind moved to a very dark place. I was driving myself crazy by living in my head 24/7, unable to switch off....

JJ's Story

There was always a dark feeling in the recesses of my mind, compelling me to complete unusual tasks in order to alleviate the panic. It wasn't until my fourteenth year that I was diagnosed with Obsessive Compulsive Disorder and depression, some seven years after I'd first become acquainted the neurotic little voice in my head.

More here....

Life is full of highs and lows. Times of happiness and joy are followed by times of grief and sadness. In times of grief and sadness, individuals cope in various ways. Some take it in their stride and may feel the grief and sadness for a short while before the feelings disappear. Others, on the other hand, may be affected severely - experiencing intense feelings of sorrow at some loss, or extreme dejection and hopelessness at their situation. For those who are severely affected, often these feelings linger on to the extent that day-to-day life becomes a major struggle and feelings of dejection, misery, hopelessness and despondency over-ride everything.

Insha'Allah, in this thread we will compile relevant information about depression from reliable sources outlining the definition, probable causes, and treatment options. More importantly, InshaAllah we intend to study depression from an Islamic point of view, looking for answers to questions such as: Does Islam address depression? Is depression condemned in Islam? Do the Qur'an and Sunnah provide preventative measures we can take against depression? Is there a cure for depression in the Qur'an and Sunnah?

ummtaalib · March 13, 2014

Views on Depression Over Time

Depression has always been a health problem for human beings. Historical documents written by healers, philosophers, and writers throughout the ages point to the long-standing existence of depression as a health problem, and the continuous and sometimes ingenious struggles people have made to find effective ways to treat this illness.

Demonic Possession

Depression was initially called "melancholia". The earliest accounts of melancholia appeared in ancient Mesopotamian texts in the second millennium B.C. At this time, all mental illnesses were attributed to demonic possession, and were attended to by priests. In contrast, a separate class of "physicians" treated physical injuries (but not conditions like depression). The first historical understanding of depression was thus that depression was a spiritual (or mental) illness rather than a physical one.

Hippocrates' View

Hippocrates, a Greek physician, suggested that personality traits and mental illnesses were related to balanced or imbalanced body fluids called humours. There were four of these humours: yellow bile, black bile, phlegm and blood. Hippocrates classified mental illnesses into categories that included mania, melancholia (depression), and phrenitis (brain fever). Hippocrates thought that melancholia was caused by too much black bile in the spleen. He used bloodletting (a supposedly therapeutic technique which removed blood from the body), bathing, exercise, and dieting to treat depression.

Cicero's View

In contrast to Hippocrates' view, the famous Roman philosopher and statesman Cicero argued that melancholia was caused by violent rage, fear and grief; a mental explanation rather than a physical one.

The View of Educated Romans

In the last years before Christ, the influence of Hippocrates faded, and the predominant view among educated Romans was that mental illnesses like depression were caused by demons and by the anger of the gods. For instance, Cornelius Celsus (25BC-50 AD) recommended starvation, shackles (leg irons), and beating as "treatments."

Persian Physicians' View

In contrast, Persian physicians such as Rhazes (865-925), the chief doctor at Baghdad hospital, continued to view the brain as the seat of mental illness and melancholia. Treatments for mental illness often involved hydrotherapy (baths) and early forms of behaviour therapy (positive rewards for appropriate behaviour).

Back to the theory of Devils, Demons & Exorcisms!

After the fall of the Roman empire in the 5th century, scientific thinking about the causes of mental illness and depression again regressed. During the Middle Ages, religious beliefs, specifically Christianity, dominated popular European explanations of mental illness. Most people thought that mentally ill people were possessed by the devil, demons, or witches and were capable of infecting others with their madness. Treatments of choice included exorcisms, and other more barbaric strategies such as drowning and burning. A small minority of doctors continued to believe that mental illness was caused by imbalanced bodily humors, poor diet, and grief. Some depressed people were tied up or locked away in "lunatic asylums".

Progress & Regress in Characterizing Depression

During the Renaissance, which began in Italy in the 14th century and spread throughout Europe in the 16th and 17th centuries, thinking about mental illness was characterized by both forward progress and regression. On the one hand, witch-hunts and executions of the mentally ill were quite common throughout Europe. On the other hand, some doctors returned to the views of Hippocrates, asserting that mental illnesses were due to natural causes, and that witches were actually mentally disturbed people in need of humane medical treatment.

In 1621, Robert Burton published Anatomy of Melancholy, in which he described the psychological and social causes (such as poverty, fear and solitude) of depression. In this encyclopedic work, he recommended diet, exercise, distraction, travel, purgatives (cleansers that purge the body of toxins), bloodletting, herbal remedies, marriage, and even music therapy as treatments for depression.

Theory in the Age of Enlightenment

During the beginning of the Age of Enlightenment (the 18th and early 19th centuries), it was thought that depression was an inherited, unchangeable weakness of temperament, which lead to the common thought that affected people should be shunned or locked up. As a result, most people with mental illnesses became homeless and poor, and some were committed to institutions.

In the latter part of the Age of Enlightenment

Some doctors and authors suggested that aggression was the real root of depression. They advocated exercise, music, drugs and diet, and stressed the importance of discussing problems with a close friend, or a doctor. Others thought that depression was caused by an internal conflict between unacceptable impulses and a person's conscience. In contrast, advances in general medical knowledge caused other scientists to believe in and search for organic (physical) causes of depression.

Therapies (Beginning of the 19th Century)

Towards the beginning of the 19th century, new therapies for depression included water immersion (keeping people under water for as long as possible without drowning them) and a special spinning stool to induce dizziness (to rearrange the contents of the brain into the correct positions). In addition, Benjamin Franklin introduced an early form of electroshock therapy. Horseback riding, special diets, enemas and vomiting were also recommended therapy.

German psychiatrist Emil Kraepelin

Depression was first distinguished from schizophrenia in 1895 by the German psychiatrist Emil Kraepelin. During this same period, psychodynamic theory was invented and psychoanalysis (the psychotherapy based upon the psychodynamic theory) became increasingly popular as a treatment for depression.

Sigmund Freud

In a 1917 essay, Sigmund Freud explained melancholia as a response to loss: either real loss (such as the death of a spouse), or symbolic loss (such as the failure to achieve an important goal). Freud believed that a person's unconscious anger over loss weakened the ego, resulting in self-hate and self-destructive behaviour. Freud advocated psychoanalysis (the "talking cure") to resolve unconscious conflicts and reduce the need for self-abusive thoughts and behaviour.

Other doctors during this time viewed depression as a physical disease and a brain disorder -

Treatments (Beginning of the 19th Century)

Treatments during the late 19th and early 20th centuries were usually inadequate for people with severe depression. As a result, many desperate people were treated with lobotomy (the surgical destruction of the frontal portion of a person's brain which had become popular as a "calming" treatment at this time). Lobotomies were often unsuccessful, causing personality changes, inability to make decisions, and poor judgment; or worse, coma and sometimes death. Electroconvulsive therapy (discussed in a later section of our paper), was a popular treatment for schizophrenics, but this treatment was also used for depressed people.

1950s and 60's: Classification that divided depression into subtypes

The medical community of the 1950s and 60's accepted a classification that divided depression into subtypes based on supposed causes of the disorder. "Endogenous" depression came from within the body and was caused by genetics or some other physical problem. People with endogenous depression were supposed to view themselves as the source of their own suffering and to think that everything was their fault. Their emotional pain was thought to be unaffected by the attitudes or responses of the people around them.

In contrast, "neurotic" or "reactive" depression was caused by some significant change in the environment, such as the death of a spouse, or other significant loss, such as the loss of a job.

Medication for Depression

In 1952, doctors noticed that a tuberculosis medication (isoniazid) was also useful in treating people with depression. Shortly after this significant finding, the practice of using medications to treat mental illness gained full steam. In response, psychiatry, which had previously looked to psychotherapy as their therapy of choice, started to emphasize the use of medications as primary treatments for mental illnesses.

Current View

Currently, rather than adopting either the mind or the body explanation of depression, scientists and mental health practitioners recognize that depressive symptoms have multiple causes. In other words, in the current view, depression can be caused by both mental and physical causes at the same time. It is no longer necessary to choose a single cause, as no single cause is going to be sufficient to explain and account for all varieties of depression. Because it has become the accepted view that depression frequently has multiple causes, including biological, psychological and social causes, it has also become the norm that multiple professions and approaches to treatment have important roles to play in helping people overcome depression.

Above Excerpts taken from Here

ummtaalib · March 13, 2014

Diagnosis of Depression

The expression ‘I feel depressed’ is used often when feeling sad or miserable about life. Usually, these feelings pass in due course. However it could be a sign of depression if these feelings persist for a long time and interferes with life.

Since depression cannot be diagnosed with any sort of laboratory testing, it must be diagnosed based upon the symptoms and medical history of the person. Medical and mental health professionals turn to manuals put out by their professional associations when diagnosing various disorders .

The following post provides information of how these diagnostic manuals used by the medical and mental health professionals came to be constructed. This will be followed by information of various other opinions of the medical profession in regards to depression.

ummtaalib · March 13, 2014

Medical Definition of Depression

How did Depression come to be Medically Defined?

Like all other diagnostic categories, depression came to be constructed over time by various medical and mental health professionals to assist in the identification, treatment, monitoring, and recording of a range of behaviours deemed to be abnormal. Medical and mental health professionals turn to manuals put out by their professional associations when diagnosing various disorders.

In the case of depression, there are currently two established systems for classifying mental disorders:

ICD (International Classification of Diseases) put out by the WHO (World Health Organization). The ICD-10 is the current standard diagnostic tool in use. It was endorsed in 1990 and came into use by WHO Member States from 1994 onward. A revised version is in the works. In the case of depression, the manual that is used more generally is the ICD.

DSM (Diagnostic and Statistical Manual) put out by the American Psychological Association (ASA) used by American professionals.
The current manual in use in America is the DSM-5 (2013) which took 14 years to produce but includes ICD codes for efficiency and consistency. While the ICD is available online for free, the DSM-5 is not (current cost is $199).

The ICD-10 lists depression (F32-33) under mood affective disorders. Depression, like all mood affective disorders under the ICD-10, are limited to clinical descriptions of emotions and behaviour, rather than any measurable physiological or biochemical factors; as such, it is particularly prone to disagreements and will likely undergo some changes in the revised version.

The DSM-5 lists depressive disorders as a distinct, separate category consisting of sub-categories. In the previous version (DSM-IV), depressive disorders were listed with bipolar and related mood disorders. While there are similarities between all mood disorders, they seem to differ in “duration, timing, or presumed etiology” (source). Now, while much of the diagnostic criteria for depressive disorders remains the same, there are some significant changes. As an example, the bereavement exclusion found in DSM-IV has been omitted from DSM-5 for a number of reasons and individuals suffering from major depression triggered by the passing of a loved-one are no longer excluded from falling under the sub-category of a major depressive episode.

From this, we understand that the medical term ‘depression’ is not necessarily fixed across cultures and time but rather, it varies over time and is regulated by the health care profession (i.e. the medical and mental health professions) for ease, efficiency, and consistency.

ummtaalib · March 13, 2014

Depression According to DSM-5

According to the DSM-5, diagnostic criteria and codes for depressive disorders are categorized under the following 8 sub-types (some links to further information included):

(1) Disruptive Mood Dysregulation Disorder - a new condition introduced in the DSM-5 to address symptoms that had been labeled as “childhood bipolar disorder” before the DSM-5′s publication. This new disorder can be diagnosed in children up to age 18 years who exhibit persistent irritability and frequent episodes of extreme, out-of-control behavior.

(2) Major Depressive Disorder, Single and Recurrent Episodes - To be diagnosed with major depression, you must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM)…

For major depression, you must have five or more of the following symptoms over a two-week period, most of the day, nearly every day. At least one of the symptoms must be either a depressed mood or a loss of interest or pleasure. Other symptoms may include:

· Depressed mood, such as feeling sad, empty or tearful (in children and teens, depressed mood can appear as constant irritability)

· Significantly diminished interest or feeling no pleasure in all — or almost all — activities

· Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected)

· Insomnia or increased desire to sleep

· Either restlessness or slowed behavior that can be observed by others

· Fatigue or loss of energy

· Feelings of worthlessness, or excessive or inappropriate guilt

· Trouble making decisions, or trouble thinking or concentrating

· Recurrent thoughts of death or suicide, or a suicide attempt

Your symptoms must be severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Symptoms can be based on your own feelings or may be based on the observations of someone else.

(3) Persistent Depressive Disorder (Dysthymia) - Dysthymia is gone, replaced with something called “persistent depressive disorder.” The new condition includes both chronic major depressive disorder and the previous dysthymic disorder. Why this change? “An inability to find scientifically meaningful differences between these two conditions led to their combination with specifiers included to identify different pathways to the diagnosis and to provide continuity with DSM-IV.”

(4) Premenstrual Dysphoric Disorder - In most menstrual cycles during the past year, five (or more) of the following symptoms occurred during the final week before the onset of menses, started to improve within a few days after the onset of menses, and were minimal or absent in the week postmenses, with at least one of the symptoms being either (1), (2), (3), or (4):

(1) marked affective liability (e.g., mood swings; feeling suddenly sad or tearful or increased sensitivity to rejection)

(2) marked irritability or anger or increased interpersonal conflicts

(3) markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts

(4) marked anxiety, tension, feelings of being “keyed up” or “on edge”

(5) decreased interest in usual activities (e.g., work, school, friends, hobbies)

(6) subjective sense of difficulty in concentration

(7) lethargy, easy fatigability, or marked lack of energy

(8) marked change in appetite, overeating, or specific food cravings

(9) hypersomnia or insomnia

(10) a subjective sense of being overwhelmed or out of control

(11) other physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” weight gain

(5) Substance/Medication-Induced Depressive Disorder – assuming this is similar to Substance-Induced Mood Disorder as listed under under DSM-IV-TR, it is a common depressive illness of clients in substance abuse treatment and is defined as “a prominent and persistent disturbance of mood . . . that is judged to be due to the direct physiological effects of a substance (i.e., a drug of abuse, a medication, or somatic treatment for depression, or toxin exposure)” (APA, 2000, p. 405). The mood can manifest as manic (expansive, grandiose, irritable), depressed, or a mixture of mania and depression.

Generally, substance-induced mood disorders will only present either during intoxication from the substance or on withdrawal from the substance and therefore do not have as lengthy a course as other depressive illnesses.

(6) Depressive Disorder Due to Another Medical Condition

(7) Other Specified Depressive Disorder

(8) Unspecified Depressive Disorder

ummtaalib · March 13, 2014

Depression According to the ICD-10

The ICD-10 conceptualizes mood disorders as a spectrum on which ‘mania’ and ‘severe depression’ fall on opposite ends. To summarize and explain mood disorders, the ICD-10 includes a somewhat lengthy yet noteworthy disclaimer which reads as follows and sheds further light on the nature of such diagnostic criteria (i.e. how they are constructed and change over time):

The relationship between etiology, symptoms, underlying biochemical processes, response to treatment, and outcome of mood [affective] disorders is not yet sufficiently well understood to allow their classification in a way that is likely to meet with universal approval. Nevertheless, a classification must be attempted, and that presented here is put forward in the hope that it will at least be acceptable, since it is the result of widespread consultation.

In these disorders, the fundamental disturbance is a change in mood or affect, usually to depression (with or without associated anxiety) or to elation. This mood change is normally accompanied by a change in the overall level of activity, and most other symptoms are either secondary to, or easily understood in the context of, such changes. Most of these disorders tend to be recurrent, and the onset of individual episodes is often related to stressful events or situations. This block deals with mood disorders in all age groups; those arising in childhood and adolescence should therefore be coded here.

The main criteria by which the affective disorders have been classified have been chosen for practical reasons, in that they allow common clinical disorders to be easily identified. Single episodes have been distinguished from bipolar and other multiple episode disorders because substantial proportions of patients have only one episode of illness, and severity is given prominence because of implications for treatment and for provision of different levels of service. It is acknowledged that the symptoms referred to here as "somatic" could also have been called "melancholic", "vital", "biological", or "endogenomorphic", and that the scientific status of this syndrome is in any case somewhat questionable. It is to be hoped that the result of its inclusion here will be widespread critical appraisal of the usefulness of its separate identification. The classification is arranged so that this somatic syndrome can be recorded by those who so wish, but can also be ignored without loss of any other information.

Distinguishing between different grades of severity remains a problem; the three grades of mild, moderate, and severe have been specified here because many clinicians wish to have them available.

According to the ICD-10, diagnostic criteria and codes for depression are categorized under 2 groups with further sub-types listed under each (please refer to pages 99-106 of the pdf bluebook for detailed information):

(1) Single depressive episode (lasting a minimum of 2 weeks, but a shorter period may be considered if symptoms are unusually severe and of rapid onset):

a. Mild depressive episode (with and without somatic syndrome) – with at least 2 key and 2 other common symptoms present, none of which are intense.

b. Moderate depressive episode (with and without somatic syndrome) – with at least 2 key and 3 (preferably 4) other common symptoms present, several of which are to a marked degree.

c. Severe depressive episode (with and without psychotic symptoms) – with all 3 key and at least 4 other common symptoms present, some of which are severe in intensity. Suicide is a distinct danger and somatic symptoms are almost always present.

d. Other depressive episodes .

e. Depressive episode, unspecified.

(2) Recurrent depressive disorder (with at least 2 episodes of depression lasting a minimum of 2 weeks separated by several months without significant mood disturbance):

a. Recurrent depressive disorder, current episode mild (with and without somatic syndrome).

b. Recurrent depressive disorder, current episode moderate (with and without somatic syndrome).

c. Recurrent depressive disorder, current episode severe (with and without psychotic symptoms).

d. Recurrent depressive disorder, currently in remission where the current state does not fulfill severity (i.e. mild, moderate, severe) or any other disorder.

e. Other recurrent depressive disorders.

f. Recurrent depressive disorder, unspecified.

The 3 key symptoms of depression, as listed in the ICD-10, are (see p.100 of the pdf bluebook):

(1) Depressed mood;

(2) Loss of interest and enjoyment; and

(3) Reduced energy leading to increased fatiguability and diminished activity.

The ICD-10 then lists the following additional common symptoms used to differentiate level of severity (i.e. mild, moderate and severe) (see p.100 of the pdf bluebook):

(1) Marked tiredness after only slight effort;

(2) Reduced concentration and attention;

(3) Reduced self-esteem and self-confidence;

(4) Ideas of guilt and unworthiness (even in a mild type of episode);

(5) Bleak and pessimistic views of the future;

(6) Ideas or acts of self-harm or suicide;

(7) Disturbed sleep; and

(8) Diminished appetite.

The ICD-10 also lists the following symptoms of somatic syndrome of which about 4 must be present, which are used to further differentiate within the mild and moderate sub-types (see p.100 of the pdf bluebook):

(1) Loss of interest or pleasure in activities that are normally enjoyable;

(2) lack of emotional reactivity to normally pleasurable surroundings and events;

(3) waking in the morning 2 hours or more before the usual time;

(4) depression worse in the morning;

(5) objective evidence of definite psychomotor retardation or agitation (remarked on or reported by other people);

(6) marked loss of appetite;

(7) weight loss (often defined as 5% or more of body weight in the past month); marked loss of libido.

As for severe depression, the ICD-10 further differentiates between those cases with and without psychotic symptoms, listing the following psychotic symptoms (see p.103 of the pdf bluebook):

(1) delusions usually involving ideas of sin, poverty, or imminent disasters, responsibility for which may be assumed by the patient

(2) auditory or olfactory hallucinations usually of defamatory or accusatory voices or of rotting filth or decomposing flesh

(3) depressive stupor, at times progressing from psychomotor retardation, but differentiated from catatonic schizophrenia, dissociative stupor, and organic forms of stupor.

ummtaalib · March 14, 2014

Investigating Various Opinions on Depression

Objections to the DSM and ICD

As seen in the section "Views on Depression Over Time", opinions on depression have varied over time. Currently the DSM and ICD are used by medical and mental health professionals to assist in the identification, treatment, monitoring, and recording of a range of behaviours deemed to be abnormal however the age old differences of opinion still exist.

Is depression an illness or is it an emotion? Is it due to some chemical imbalance in the brain or is it due to an imbalance in the humors?

Some are of the opinion that depression is neither an illness nor due to chemical imbalances but rather that depression is an emotion. Here is more on this view:

Depression is not an Illness

This month’s issue of The British Journal of General Practice contains an editorial “Depression as a culture-bound syndrome: implications for primary care” by Dr. Christopher Dowrick, Professor of Primary Medical Care at the Institute of Psychology, Health, and Society of the University of Liverpool. Dr. Dowrick claims that depression “fulfills the criteria for a culture-bound syndrome,” i.e. , one of the “’illnesses’, limited to specific societies or culture areas, composed of localized diagnostic categories,” like, for instance ataque de nervios in Latin America.

In the case of depression the culture area affected is “westernized societies.” Putting the word “illness,” when applied to culture-bound syndromes into quotation marks indicates that Dr. Dowrick does not consider such syndromes real illnesses; it follows that depression--a culture-bound syndrome of westernized societies--is also not a real illness. Dr. Dowrick further argues that depression as a diagnostic category cannot be seen as “a universal, transcultural concept,” because it has no validity and utility, and it does not have validity and utility, because “there is no sound evidence for a discrete pathophysiological basis” for depression.

Depression is NOT a Chemical Imbalance in Your Brain

This powerful [audio] contains interviews with experts, parents and victims. It is the story of the high-income partnership between drug companies and psychiatry which has created an $80 billion profit from the peddling of psychotropic drugs to an unsuspecting public. How did these drugs, with no target illness, no known curative powers and a long and extensive list of side effects, become the go-to treatment for every kind of psychological distress? Source

Are Emotional Symptoms Really Signs of Mental Illness? Clearly, there are "real" mental illnesses that can destroy any semblance of normalcy in a person's life. But are you mentally ill when you're sad for more than a couple of weeks?

Is losing zest for life a sign of mental illness?

Where does the normal grieving process fit into our modern lives—is it something that should be drugged, or is it a normal phase of life that everyone on the planet has to move through? And when does an emotional phase go from being a natural part of the changing emotional landscape that is life to a problem that needs to be "fixed"?

Many are quick to defend their choice to take drugs. No one wants to "feel bad." But are these drugs destroying lives rather than saving them?

Depression is an Emotion not a Disease

Depression should be viewed as an emotion rather than a disease, according to the authors of a controversial new book. Consultant psychiatrist Dr Michael Corry of Clane General Hospital and Dublin psychotherapist Dr Aine Tubridy question the widespread use of drugs to treat depression, saying it is more "band-aid" than cure. PDF

The Book "Depression An Emotion Not A Disease"

Is there any end to the cycle of relapse, hospitalisation and medication for sufferers of depression? Drs Michael Corry and Áine Tubridy believe there is. In this hard-hitting new book, Corry and Tubridy present a revolutionary new perspective in which they assert that depression is an emotion, just like fear, anger or love, that can be consciously influenced, rather than a disease which can only be suffered. This new theory has enormous implications for the traditional treatment of depression. It puts the sufferer back at the centre of a more individual and tailored approach to healing and raises serious questions about the medical communities focus on medication as a primary treatment. Depression speaks both to those experiencing depression and to their families. Its aim is to: offer hope and understanding; equip sufferers with the resources to buffer them against future setbacks; end the cycle of relapse and remedicate; provide effective ways to create a new identity for the sufferer, rooted in self-acceptance and empowerment.

Four Humors; Hippocrates

When today's doctor prescribes an antibiotic to fight infection, he is trying to put the patient's body back in balance. While the drugs and medical explanation may be new, this art of balancing bodily fluids has been practiced since Hippocrates' day. Source

Four temperaments is a proto-psychological theory that suggests that there are four fundamental personality types, sanguine (pleasure-seeking and sociable), choleric (ambitious and leader-like), melancholic (analytical and literal), and phlegmatic (relaxed and thoughtful). Most formulations include the possibility of mixtures of the types.

The Greek physician Hippocrates (460–370 BC) incorporated the four temperaments into his medical theories as part of the ancient medical concept of humorism, that four bodily fluids affect human personality traits and behaviors. Later discoveries in biochemistry have led modern medicine science to reject the theory of the four temperaments, although some personality type systems of varying scientific acceptance continue to use four or more categories of a similar nature. Wikipedia

Medication: antidepressants

Conclusion: nothing definitive on diagnosis or treatment...yet depression is a reality

ummtaalib · March 14, 2014

Causes of Depression

It is important to note that there appears to be no simple or definitive answer to what causes depression. Below is a compilation of various opinions.

There is no single cause of depression. You can develop it for different reasons and it has many different triggers. Source

There’s no simple answer as to why people become depressed. It’s often a combination of things and it varies from person to person. We do know that some people are more likely to become depressed than others. Depression can also be triggered by a difficult situation in your life, or it can build up over many years. Sometimes there’s no obvious reason. Source

Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors.

Depressive illnesses are disorders of the brain. Longstanding theories about depression suggest that important neurotransmitters—chemicals that brain cells use to communicate—are out of balance in depression. But it has been difficult to prove this. Source

There are many potential causes of depression. Some depression runs in families, and researchers believe it's possible to inherit a tendency towards depression; this seems to be especially true for bipolar disorder (manic depression). Studies of families with several generations of bipolar disorder (BPD) found that those who develop the disorder have differences in their genes from most who don't develop BPD. But some people with the genes for BPD don't actually develop the disorder. Other factors, such as stresses at home, work, or school, are also important.

Major depression also seems to run in families, but it can develop in people who have no family history of depression. Either way, major depressive disorder is often associated with changes in brain structure or function.

People who have low self-esteem, who are consistently pessimistic, or who are readily overwhelmed by stress are also prone to depression. Physical changes in the body can also trigger mental health problems such as depression. Research demonstrates that stroke, heart attack, cancer, Parkinson's disease, and hormonal disorders can cause depression. A severe stressor such as a serious loss, difficult relationship, financial problem can also trigger a depressive episode. A combination of genetic, psychological, and environmental factors is often involved in the onset of depression. Source

What Causes Depression?

(This article was first printed in Understanding Depression, a Special Health Report from Harvard Medical School.)

It’s often said that depression results from a chemical imbalance, but that figure of speech doesn’t capture how complex the disease is. Research suggests that depression doesn’t spring from simply having too much or too little of certain brain chemicals. Rather, depression has many possible causes, including faulty mood regulation by the brain, genetic vulnerability, stressful life events, medications, and medical problems. It’s believed that several of these forces interact to bring on depression.

To be sure, chemicals are involved in this process, but it is not a simple matter of one chemical being too low and another too high. Rather, many chemicals are involved, working both inside and outside nerve cells. There are millions, even billions, of chemical reactions that make up the dynamic system that is responsible for your mood, perceptions, and how you experience life.

With this level of complexity, you can see how two people might have similar symptoms of depression, but the problem on the inside, and therefore what treatments will work best, may be entirely different.

Researchers have learned much about the biology of depression. They’ve identified genes that make individuals more vulnerable to low moods and influence how an individual responds to drug therapy. One day, these discoveries should lead to better, more individualized treatment (see “From the lab to your medicine cabinet”), but that is likely to be years away. And while researchers know more now than ever before about how the brain regulates mood, their understanding of the biology of depression is far from complete.

What follows is an overview of the current understanding of the major factors believed to play a role in depression. Read More....

Below are some contributing factors:

Family History

other members of your family having depression
traumatic experiences in childhood, including violence

Not everyone is lucky enough to be brought up in a stable and loving family environment, and bad experiences during childhood can increase the risk of developing depression. However there are plenty of people who suffer from depression who had great childhoods, and plenty who had a tough time in childhood who don’t get depressed. Depression is usually the result of a combination of factors.

There’s always a possibility that depression could be genetic, and there does seem to be an increase in risk of depression where other family members have experienced it. But just because a family member has had depression at some stage, doesn’t mean that you will too.

Events

death or loss of someone close
relationship break-ups
traumatic, often life threatening events (illness)
financial pressure
unemployment
serious accidents (particularly head injuries) or long-term illness
some medication (check with your doctor)
stress or problems at work, school or university or on the farm
bullying or abuse
some women experience depression during pregnancy or after childbirth
Natural events such as drought or earthquakes

Stressful life events and long term serious difficulties can trigger depressive episodes. Losing a job, a close friend or family member dying, or a relationship break-up is hard for anyone to cope with, but for some people it can seem impossible to recover.

Lifestyle

excessive alcohol consumption
recreational or party drugs
social isolation
lack of sleep
poor diet and lack of exercise

Giving Birth

Some women are particularly vulnerable to depression after pregnancy. The hormonal and physical changes, as well as added responsibility of a new life, can lead to postnatal depression.

During Menstruation

Some women experience mood swings right before and during their menstrual cycles. However, serious depression is not typical and should not be overlooked.

ummtaalib · March 14, 2014

Suicide

Every year, an estimated 900 000 people die by committing suicide. This represents one death every 40 seconds. Worldwide, suicide ranks among the three leading causes of death among those aged 15-44 years. WHO

The World Health Organisation defines suicide as an act deliberately initiated and performed by a person in the full knowledge or expectation of its fatal outcome. Data on suicide rates are based on official registers of causes of death.

Suicide Risk Factors

Risk factors are often confused with warning signs of suicide, and frequently suicide prevention materials mix the two into lists of “what to watch out for.” It is important to note, however, that factors identified as increasing risk are not factors that cause or predict a suicide attempt. Risk factors are characteristics that make it more likely that an individual will consider, attempt, or die by suicide. Protective factors are characteristics that make it less likely that individuals will consider, attempt, or die by suicide.

Risk Factors for Suicide

Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders and certain personality disorders
Alcohol and other substance use disorders
Hopelessness
Impulsive and/or aggressive tendencies
History of trauma or abuse
Major physical illnesses
Previous suicide attempt
Family history of suicide
Job or financial loss
Loss of relationship
Easy access to lethal means
Local clusters of suicide
Lack of social support and sense of isolation
Stigma associated with asking for help
Lack of health care, especially mental health and substance abuse treatment
Cultural and religious beliefs, such as the belief that suicide is a noble resolution of a personal dilemma
Exposure to others who have died by suicide (in real life or via the media and Internet)

Protective Factors for Suicide

Effective clinical care for mental, physical and substance use disorders
Easy access to a variety of clinical interventions
Restricted access to highly lethal means of suicide
Strong connections to family and community support
Support through ongoing medical and mental health care relationships
Skills in problem solving, conflict resolution and handling problems in a non-violent way
Cultural and religious beliefs that discourage suicide and support self-preservation

ummtaalib · March 14, 2014

Medical Treatment Options

Though there are many treatment options available it can be quite daunting to begin the journey of recovery. As one sufferer of depression said, "The journey to healing and recovery is definitely a marathon event."

The Cycle of Depression

A European study showed that depression and fatigue fuel each other in a vicious cycle, with patients suffering from depression being four times more likely to suffer fatigue. Patients suffering from fatigue are three times more likely to become depressed. While the researchers were quick to point out that the two conditions have separate causes, they appear to feed off of each other in a cycle that can be difficult to break. Source

The symptoms of depression can bring about some drastic changes in a depressed person’s life, daily routines, and their behaviour. Often it is these changes that makes the depression worse and prevents the depressed person from getting better. Low energy and fatigue leads to decreased activity which leads to feelings of ineffectiveness and hopelessness. This results in the depression worsening. It is known as the Cycle of Depression.

Reversing the Cycle

The following PDF explains further with tips on how to reverse the cycle of depression.

Info-Vicious Cycle of Depression.pdf

Treatment Options Available

Treatment will depend on the type of depression a person is diagnosed with. Below is a list of some of the many different types of treatment options available.

For Mild Depression

Watchful Waiting: wait and see if it disappears
Exercise: is known to help mild depression
Self help Groups: talking about it helps

Mild to Moderate Depression

There appear to be different types of talking therapies like Psychotherapy and counselling.

Severe Depression

Medication: anti-depressants may be prescribed by the doctor
Combination Therapy: the doctor may recommend medication with talking therapy
Mental health teams : In severe depression, the patient may be referred to a mental health team made up of psychologists, psychiatrists, specialist nurses and occupational therapists. These teams often provide intensive specialist talking treatments as well as prescribed medication.

ummtaalib · March 14, 2014

Alternative Treatments

Alternative or complementary therapies include:

Acupuncture
Aromatherapy
Biofeedback
Chiropractic treatments
Guided imagery
Herbal remedies
Hypnosis
Massage therapy
Meditation
Relaxation
Yoga

The mental health charity Mind says it cannot endorse complementary therapies, but does say some people find them helpful.

Finding a reputable therapist is important. The Complementary and Natural Healthcare Council (CNHC) is a government-backed regulator of complementary therapists. Some therapies also have their own professional body.

Source

The Holistic Approach

If you’re depressed, taking medication is only one of many treatment options. A holistic approach focuses on treating your whole being -- body and mind -- to help you feel better. A healthy diet, exercise, and talk therapy are a few of the holistic approaches you can use, along with your medication, to help speed recovery from depression.

Source

Herbal Remedies

Looks at Herbal remedies used by many people suffering from anxiety or depression.

"In this article, I will review the evidence for or against herbal remedies as treatments for depression and anxiety. My assessment is based on a systematic review of the published literature...."

Source

How To Treat Depression Naturally

Highlighting the importance of being able to feel sad sometimes and urging caution on the use of anti-depressants, a doctor writes:

"As an MD, I’ve watched too many of my colleagues yank out anti-depressant samples every time a patient starts to cry. So on behalf of physicians everywhere, let me apologize for our trigger-happy prescription-writing behaviour. I don’t mean to diminish the pain someone who is depressed might experience. But tears are healthy. Sadness doesn’t always need treatment. And it’s important to remember that the pain muscle and the joy muscle are the same. If you can’t feel one, you won’t feel the other............."

Source

ummtaalib · March 14, 2014

To Conclude the Medical Aspect

Alhamdulillah, so far we examined the medical aspect of depression – from various definitions, types, symptoms, causes, and treatment options, to changing diagnostic criteria as set by the World Health Organization (WHO) and the American Psychiatric Association (APA).

As we move on to examine the Islamic perspective on depression in coming posts, please bear the following key findings in mind:

* there is no universal, stable medical definition for depression, nor is there agreement on the causes, symptoms and treatment of depression;

* the diagnostic category ‘depression’ came to be constructed over time by various medical and mental health professionals and continues to change; and

* generally speaking, depression appears to be triggered by stressful conditions or events and can vary in severity from mild/temporary episodes of sadness, to severe/persistent episodes of extreme sadness and hopelessness.

Regardless of definition, triggers or severity, depression affects an incredibly high number of people of all ages and backgrounds. In its severest form, depression is debilitating and soul destroying, often leading to suicidal thoughts.

ummtaalib · March 18, 2014

Depression & Islam

The medical aspect aside, there are countless heart rending stories out there of people suffering from depression related symptoms, including a great number of stories of Muslims - as is evident from pleas for help and advice sent to Islamic scholars, online.

Does Islam Condemn Depression?

What is the Islamic perspective on depression?

Is depression denied and ignored in Islam?

Is depression dismissed as "weak faith" by the Muslim scholars?

What types of advice do Muslim scholars offer to sufferers of depression?

Insha'Allah, we hope to provide some scholarly answers and advice related to the above listed questions. It is hoped that this collection will help demonstrate how Muslim scholars attend to the issue of depression and how they provide assistance to sufferers - giving them hope, beneficial advice and encouragement.

Depression: Deficiency of Faith?

Question: Shaykh could you please give you sincere advice on how to get rid of depression I’m a student and it is really affecting my studies? Is due to a deficiency of imaan?

Answer: Depression could be for a variety of reasons- we should seek help of experts of every field. If my car broke down, I would try to find the best mechanic. Similarly, you should try to see the best physician. Talk to your G.P. See if he can refer you to a good reliable psychiatrist. They are very professional. They interview you and get to the root of the problem. Then they prescribe the medicine.

Maintain a healthy sleep pattern, sleep early, avoid TV before sleeping, don’t sit on the computer too much, eat healthy food and lastly pray Namaaz with punctuality and cry before Allah after every Namaaz Tafseer Raheemi

Muslims & Depression?

Question: Ideally a Muslim should not suffer from depression, is that a correct assumption?

Answer: Depression, distress, and sadness can indicate a weakness of faith if they arise out of dissatisfaction with the way Allah has Willed things. However, often they arise as a result of trials in life, without one’s choosing. In such situations, our duty is to be patient, thankful for one's countless blessings, and certain that Allah only gives His servants that which is best for them. Source

Alhamdulillah, far from condemning depression, Islam provides the answer and insha'Allah we will look at it in more detail in coming posts through a compilation of quotes from the Scholars of Islam.

ummtaalib · March 18, 2014

What do the Scholars of Islam say about Depression?

Regarding whether "Depression" as we know it, is mentioned in the Qur'an and Sunnah, we have the reply of Shaykh Zubair Dudha, the Khalifah of Arifbillaah Shaykh Hakeem Akhtar (Raheemahullah) and the founder of the Isalmic Tarbiyah Academy

With regards to depression. There is nothing in the Qur'an or Hadith specifically describing depression. Neither is such a word found in the Arabic or Urdu language or such described in any malfoozat of the elders.

The closest to depression mentioned in the Hadith is the word Huzn (Grief/Sorrow). Various Ahaadith mention the cure for Huzn in the form of Duas.

I would understand depression as being continuous huzn, un enabling a person to snap out of it eventually becoming an illness.

In his talk on “the Solution to all Your Problems” Shaykh Hasan Ali notes that, while Allah Ta’aala gives us various situations (e.g. loss, illness, etc.), we cause ourselves stress by opening the door of ‘if’ and this can lead to depression.

Abu Huraira reported Allah's Messenger (may peace be upon him) as saying: "A strong believer is better and is more lovable to Allah than a weak believer, and there is good in everyone, (but) cherish that which gives you benefit (in the Hereafter) and seek help from Allah and do not lose heart, and if anything (in the form of trouble) comes to you, don't say: If I had not done that, it would not have happened so and so, but say: Allah did that what He had ordained to do and your "if" opens the (gate) for the Satan." The Book of Destiny (Kitab-ul-Qadr) of Sahih Muslim

He says:

Stress is created by people themselves. They open the door of “if… if… if…” The best thing you can do - brother and sister - is close that door of ‘if.’ Say: “Allah has willed it, it has happened” and move on. Move on and do something positive.

He lists patience, salaah, making du’aa, trusting Allah Ta’aala, getting out of the environment and doing positive things, and smiling and laughing (the way Rasulullah [sallallahu alayhi wa sallem] used to, with his teeth closed) as useful strategies in relieving stress.

Mufti Ebrahim Desai

Q. What is the cause of the anxiety and depression?

A. It is important to treat the cause. Duas alone are not sufficient to overcome anxiety and depression. We are living in a world of cause and effect and in the world of means. To diagnose a problem and adopt means for cure is the teaching of Shariah. Rasulullah salallahu alayhi wasallam and the Sahaba radi allahu anhum faced various challenges in their lives.

They attempted to identify the cause of the problems and adopted means to remedy the problems. Yes, they took strength and courage through Salah and Duas.

At times our own actions lead us to anxiety and depression. The remedy is then simple. Self reformation. In such a situation ones can make any amount of dua and Dhikr, his wrong deeds will still drown him in grief and depression.

This life is filled with challenges and adversities. It is natural to feel anxious and experience grief. The best solution for such feelings is to remind ourselves that we are Muslims and we are sent in this world to be tested.

A feeling of anxiety is actually a test from Allah. Allah want to see our reaction. We are caught between the order of Allah and our Nafs. To control ones Nafs at this time and remind ourself of Allahs test is what Allah wants from us. It is then Allah’s help will come. It is the barakaat of such submission, duas and Dhikr that Allah will guide one to the road of relief and comfort.

Allah Ta’ala tells us

يَا أَيُّهَا الَّذِينَ آمَنُوا اسْتَعِينُوا بِالصَّبْرِ وَالصَّلَاةِ إِنَّ اللَّهَ مَعَ الصَّابِرِينَ

O you who believe! Seek assistance through patience and Salah.
Indeed Allah with those who are the patient ones.

(Qur’an 2:153)

ummtaalib · March 18, 2014

Depression: The Illness

From the above quotes it is clear that depression as defined by medical professionals is not specifically mentioned in the Qur'an or Hadith. Yet depression is a reality and a serious, debilitating illness especially because of the tendency towards suicidal thoughts and suicide itself. In order to truly understand the Islamic perspective, the following quote from Shaykh Zubair Dudha is mentioned once more;

I would understand depression as being continuous huzn, un enabling a person to snap out of it eventually becoming an illness.

We shall inshaAllah compile information on "Huzn" to enable us to understand depression from the Islamic perspective in the following post. For depression the illness, we are advised to seek medical help....

Depression is a very serious affliction that can’t be dealt with in isolation. While this answer will address some of your doubts, your suicidal thoughts indicate a deeper problem that cannot be solved over the internet. Therefore, I strongly encourage you to seek the help of a qualified counselor.

Seeking proper help is of utmost importance, and Allah commands us in the Qur’an to seek qualified advice if we are unsure about something (16:43). Similarly, a hadith relates that when two of the companions gave bad advice to an injured man that resulted in his death, the Prophet (peace be upon him) proclaimed, “Do you not ask if you do not know?” [Abu Dawud] Seekersguidance

Question: Shaykh could you please give you sincere advice on how to get rid of depression I’m a student and it is really affecting my studies? Is due to a deficiency of imaan?

Answer: Depression could be for a variety of reasons- we should seek help of experts of every field. If my car broke down, I would try to find the best mechanic. Similarly, you should try to see the best physician. Talk to your G.P. See if he can refer you to a good reliable psychiatrist. They are very professional. They interview you and get to the root of the problem. Then they prescribe the medicine.

Maintain a healthy sleep pattern, sleep early, avoid TV before sleeping, don’t sit on the computer too much, eat healthy food and lastly pray Namaaz with punctuality and cry before Allah after every Namaaz Tafseer Raheemi

Question: Are anti depressants allowed?

Answer: Medication is permissible. If the medication has some drowsy effect then it should be taken only when necessary and with the advise of a physician. muftisays.com

ummtaalib · March 18, 2014

Grief/Sorrow/Anxiety/Distress etc.in the Qur'an and Hadith

As mentioned by Shaykh Mufti Zubair Dudha, depression as we know it is not specifically mentioned in the Qur'an or Hadith. The closest to it in meaning which are mentioned in the Qur'an and Hadith are "Hamm" and "Huzn" as well as "Ghamm".

The following is a compilation of the Du'a and Qur'anic verses which make mention of these words.

Du'a from Hadith:

اللهم إني أعوذ بك من الهم والحزن والعجز والكسل والجبن والبخل وضلع الدين وغلبة الرجال

رواه البخاري ومسلم والنسائي.

"O Allāh, I take refuge in You from anxiety and sorrow, weakness and laziness,

miserliness and cowardice, the burden of debts and from being overpowered by men."

"Huzn" in the Qur'an:

بَلَىٰ مَنْ أَسْلَمَ وَجْهَهُ لِلَّهِ وَهُوَ مُحْسِنٌ فَلَهُ أَجْرُهُ عِندَ رَبِّهِ وَلَا خَوْفٌ عَلَيْهِمْ وَلَا هُمْ يَحْزَنُونَ

Bala man aslama wajhahu lillahi wahuwa muhsinun falahu ajruhu 'inda rabbihi

wala khawfun 'alayhim wala hum yahzanoon (Qur'an 2:112)

"Nay, but whosoever surrendereth his purpose to Allah while doing good, his reward is with his Lord;

and there shall no fear come upon them neither shall they grieve"

أَلَا إِنَّ أَوْلِيَاءَ اللَّهِ لَا خَوْفٌ عَلَيْهِمْ وَلَا هُمْ يَحْزَنُونَ

Ala inna awliyaa Allahi la khawfun 'alayhim wala hum yahzanoon (Qur'an 10:62)

"Lo! verily the friends of Allah are (those) on whom fear (cometh) not, nor do they grieve"

"Baththa" - Extreme sorrow/anguish

In the following verse, along with "Huzn", the word "Bathth" is used which means extreme sorrow/anguish (شدت الحزن)

قَالَ إِنَّمَا أَشْكُو بَثِّي وَحُزْنِي إِلَى اللّهِ وَأَعْلَمُ مِنَ اللّهِ مَا لاَ تَعْلَمُونَ

"He said, .I do not complain of my anguish and sorrow to anyone but Allah, and I know from Allah what you do not know." (Qur'an 12:86)

What exactly are Hamm and Huzn?

Imam Ibn Ul Qayyim Jawzi rahimahullah mentions about the above Hadeeth that Nabi sallAllahualayhiwasallam sought refuge from 8 things; every two are opposites [The first two being:]

Hamm is anticipating evil in the future and Huzn is pain upon receiving a disliked thing or the loss of a liked thing in the past. Both of them are painful and punishing upon the soul. If related to the past it is names Huzn and if related to the future it is named Hamm.

Other Mashaikh explain Hamm & Huzn as follows with a third category called Ghamm:

The emotional pain that the heart experiences in relation to past affairs is called Huzn (sadness/grief). If the emotional pain is related to future concerns, it is called Hamm (worry, anxiety). If the emotional suffering is regarding the present, this is known as Ghamm (distress).

"Ghamm" in the Qur'an:

ثُمَّ أَنزَلَ عَلَيۡكُم مِّنۢ بَعۡدِ ٱلۡغَمِّ أَمَنَةً۬ نُّعَاسً۬ا يَغۡشَىٰ طَآٮِٕفَةً۬ مِّنكُمۡ‌ۖ

"Then, after grief, He sent down security for you. As slumber did it overcome a party of you" (Qur'an 3:154)

al-Hamm: Hamm means 'to make uneasy and fill with anxiety'. It is the type of distress one feels that affects the mind, heart, and body. This sadness worries a person, and one's sole concern is this sadness. Hamm leaves a person preoccupied with one's thoughts, going over them again and again in the mind, because it is an anxiety that one has regarding something that may or may not happen. If you have ever felt this type of sadness, that anxious and nervous feeling, you know how debilitating it can be.

al-Hazan: Huzn also means sadness but it is different than Hamm. Huzn is grief arising on account of an unpleasant event that has happened, such as the death of a loved one or a distressing situation. In the sīrah, the year that Abu Talib and Khadija (radi Allahu anha) died is known as 'Aam al Huzn, the Year of Grief. In the Qur'an, Allāh ta'ala mentions many times that the Believers will not “yahzanoon“, have grief, this means that in the hereafter, the believers will not grieve over anything that has occurred in the past. Huzn means 'to be full of sorrow,

mourning, grief, and saddened'.

ummtaalib · March 18, 2014

Trials are a part of Life & we WILL be Tested

As we have seen, the causes of depression are many, often with more than one factor contributing to it. Stressful situations like divorce, death of a loved one, loss of a job, illness, etc. can become contributing factors to depression. Such trials are common place in the lives of both Muslims and non Muslims.

We are, by the grace of Almighty Allah, Believers, and as Believers in every situation we turn to the true and eternal faith. As Believers we know we shall be tested as Allah says in the Holy Qur’an,

“Do people think that they will be left alone because they say, we believe, and will not be tested?

And indeed We tested those who were before them” (Ankaboot, 2-3)

"Be sure we will test you with something of fear and hunger, some loss in goods or lives, but give glad tidings to those who are steadfast, who say when afflicted with calamity: 'To Allah we belong and to him is our return..' They are those on who (descend) blessings from Allah and mercy and they are the once that receive guidance." (Al-Baqarah: 155)

Why the Tests? Is it due to our Sins?

Difficulties do not always come about because of sin. If this was indeed the case, the prophets would never have suffered any misfortune.

Sometimes, Allah Ta’ala inflicts minor calamities that prevent major calamities. Sometimes, people are tested by Allah Ta’ala to ascertain their degree of forbearance before Allah. Difficulties are also a cause for reward and elevation of one’s status in the hereafter. Continue making Du’aa and beg Allah’s Aafiyat (security and safety from all form of misfortune). Allah Ta’ala Knows Best. Mufti Ebrahim Desai

Allah knows we can Handle it

In the end, we should remember that this life is a life of trial and tribulation. We are being tested because Allah knows that we can handle it, and He seeks to raise our ranks by means of these tests and to cleanse our hearts from the darkness of sin. So, for this, we should constantly thank Allah and see our states as indicative of His perfection.

Abu Sa’id and Abu Hurayra reported that the Prophet, may Allah bless him and grant him peace, said, “No fatigue, illness, anxiety, sorrow, harm or sadness afflicts any Muslim, even to the extent of a thorn pricking him, without Allah wiping out his mistakes by it.” [al-Bukhari, Muslim] Abu Hurayra also reported that the Messenger of Allah may Allah bless him and grant him peace, said, “When Allah desires good for someone, He afflicts him.” [al-Bukhari] Seekersguidance

Allah mentions in the Holy Qur'an,

‘Allah does not impose a soul except according to its capability…’

(Surah Al-Baqarah, verse 286)

ummtaalib · March 18, 2014

The Purpose of Trials & Tests

Trials and tests are a sign of Allah’s love for a person, because they are like medicine: even though it is bitter, despite its bitterness you give it to the one whom you love.

The Messenger of Allah (Allah bless him and give him peace) said, “If Allah loves a servant, He sends them tests.”

Our response to the trials Allah sends us should be to turn to Him, in patience, contentment, submission, and thankfulness for His countless blessings. Shaykh Faraz Rabbani

The Divine Wisdom Behind Suffering

Many times, we do not understand the Divine Wisdom behind suffering in this world, and hence, we rush to the judgment that it should not take place, or that Allah is obliged to remove it. People are even led to atheistic thoughts when they erroneously ask themselves how Allah could allow such a thing to occur.

In Islam, the question of suffering in this world, called theodicy, is easily answered when two things are put into proper context: 1) that there is an All-Wise Creator who has created us all that we might worship Him, and 2) that we return to Him for an eternal life after this temporary worldly life, the nature of which will be determined by the choices we make in our lifetimes.

For Muslims in this world, every good they do, they are rewarded for, and every difficulty or calamity that they bear patiently with, some of their sins are wiped out or they are given reward for. Their entering Paradise however, is not by their deeds or rewards, but through Allah Most High’s mercy upon His believing servants.

Source

ummtaalib · March 18, 2014

How can Trials & Tests Benefit a Muslim?

Calamities benefit the believer because reward is stored up for him/her in the Hereafter thereby he/she is raised in status and his/her bad deeds are expiated. Hadith books are full of promises of such reward by which a Believer can take comfort.

Greatest Reward comes with the Greatest Trial

“The greatest reward comes with the greatest trial. When Allah loves a people He tests them. Whoever accepts that wins His pleasure but whoever is discontent with that earns His wrath.” Narrated by al-Tirmidhi (2396) and Ibn Maajah (4031)

Good for the Believer in Peace and Adversity

Man is tested with both trials and tranquillity both of which are a way of attaining the pleasure of Allah and everlasting peace. The Prophet sallallaahu 'alayhi wasallam said,

“How amazing is the case of the believer; there is good for him in everything, and this is only so for the believer. If he experiences something pleasant, he is thankful, and that is good for him; and if he comes across adversity, he is patient, and that is good for him.” [Muslim]

Sorrow/Grief Wipes away Sins

Hadrat Abu Sa'eed Khudri (Radhiallaahu Anhu) reports that Rasulullah (Sallallaahu Alayhi Wasallam) said, 'When a Mu'min experiences any fatigue, disease, sorrow, grief, hurt or distress, even to the extent that if a thorn has to prick him, Allah Ta'ala wipes away some of his sins for that.' (Sahih Bukhaari)

Sickness Compensates for our Sins

Hadrat Abdullah bin Mas'ood (Radhiallaahu Anhu) reports that Rasulullah (Sallallaahu Alayhi Wasallam) said, 'Whenever a Muslim experiences any hardship like sickness (etc.), Allah Ta'ala wipes away his sins just as a tree sheds its leaves during autumn.' (Bukhaari and Muslim)

Affliction leads to Sins Falling Away

Hadrat Abu Hurairah (Radhiallaahu Anhu) reports that Rasulullah (Sallallaahu Alayhi Wasallam) said, 'Afflictions continuously fall upon the lives, wealth and children of those men and women who have Imaan as a result of which, their sins keep falling off from them until such time that they (die and) meet Allah in the state that none of their sins remain.' (Tirmizi, Maalik)

Hardship leads to High Ranks

Rasulullah (Sallallaahu Alayhi Wasallam) has also said, '(Sometimes) a very high rank (in Allah's sight) is decreed for a Mu'min which he could never have attained by virtue of his deeds, so Allah Ta'ala lets him experience some hardship, whether it be physical, material (financial, etc.) or concerning his children. Then, He makes him patient and lets him attain the position decreed for him.' (Ahmad, Abu Dawood) Therefore, although it is bitter to bear calamities and misfortunes with patience, we should consider it sweet in view of the great bounty attainable through it. The difficulty and hardship of only a few days will be followed by a life of eternal happiness, Inshaa Allah.

Angels Continue writing good deeds for the Sick

Hadrat Abdullah bin Umar (Radhiallaahu Anhu) reports that Rasulullah (Sallallaahu Alayhi Wasallam) said, 'When a (righteous) person (who dutifully performs his ibaadah) becomes sick, the angels appointed to record his deeds are instructed by Allah Ta'ala: Continue recording in his Book of Deeds those actions which he used to perform when he was healthy, until he either gets better or I call him unto Me.'

Angels Continue writing good deeds for the Sick and those on a Journey

Hadrat Abu Moosa (Radhiallaahu Anhu) reports that Rasulullah (Sallallaahu Alayhi Wasallam) said, 'When a person becomes sick or goes on a journey, then those (good) deeds are written down in his favour which he used to perform when he was at home and in good health.' (Sahih Bukhaari)

Reward as Compensation for Enduring Hardship

Hadrat Jaabir (Radhiallaahu Anhu) reports that Rasulullah (Sallallaahu Alayhi Wasallam) said, 'On the Day of Qiyaamah, when people will be given their sawaab (reward) in compensation for their suffering and difficulties in the world, then those people who had always lived a life of ease and comfort will (regretfully) wish that their skins were cut with scissors in the world.' (Tirmizi)

Glad Tidings for the Blind

Hadrat Anas bin Maalik (Radhiallaahu Anhu) reports that he heard Rasulullah (Sallallaahu Alayhi Wasallam) saying that Allah Ta'ala said, 'If I deprive My slave of his two beloved possessions (i.e. his eyes) and he bears it patiently, I will let him enter Jannah in compensation for them.' (Sahih Bukhaari)

Fever Wipes out Sins

Once Rasulullah (Sallallaahu Alayhi Wasallam) went to the home of Umm Saa-ib (Radiyallaahu anha) and asked her, 'What is the matter? Why are you shivering?' She replied, 'I have a fever. May Allah not bless it!' Rasulullah (Sallallaahu Alayhi Wasallam) said, 'Do not curse fever since it wipes out the sins of the Children of Aadam just as a furnace removes dirt from iron.' (Sahih Muslim)

Shaykh al-Islam [ibn Taymiyah] (may Allah have mercy on him) said: A calamity that makes you turn to Allah is better for you than a blessing which makes you forget the remembrance of Allah.”

Sufyaan said: What a person dislikes may be better for him than what he likes, because what he dislikes causes him to call upon Allah, whereas what he likes may make him heedless.

ummtaalib · March 18, 2014

Tears will Fall & Hearts will Break!

To feel grief is beyond one’s control and to shed tears is not against the concept of patience. If patience is in the heart, the body will remain in control and one’s actions will be those that please Allah. One’s tongue will not utter that which displeases Allah and one will continue to fulfil one’s duties to Allah and the Creation.

Why me? What did I do to deserve this? I pray the five Salaat and still Allah did this?

These statements, made when afflictions and calamities strikes are contrary to Sabr (Patience). Words of complaint and anger directed at Allah ta'ala, impatience, despair etc. cannot change or prevent the decree of Allah ta'ala. Grief and heartache are present at some calamity or loss of a loved one however Muslims are taught not to say that which is contrary to Sabr.

At the death of his beloved son Ibrahim, our beloved Prophet Muhammad sallallaahu 'alayhi wasallam started shedding tears at which a Companion, ‘Abdur Rahman bin ‘Auf said, “O Allah’s Apostle, even you are weeping!”

He said, “O Ibn ‘Auf, this is mercy.”

Then he wept more and said, “The eyes are shedding tears and the heart is grieved, and we will not say except what pleases our Lord, O Ibrahim ! Indeed we are grieved by your separation.” (Sahih Bukhari, Book #23, Hadith #390)

When Prophet Ya'qoob AS despaired of ever seeing his son Yusuf AS, he turned to Allah, and the Qur'an tells us that he beseeched Him for relief.

“He said: ‘I only complain of my grief and sorrow to God, and I know from God that which you know not.’” (Quran 12:86)

The Qur'an also tells us that Prophet Ayyoob AS turned to Allah begging of His mercy. He was impoverished, stricken with disease, and he lost his family, friends, and livelihood yet he bore all this with patience and forbearance and turned to Allah.

“And (remember) Job, when he cried to his Lord, ‘Verily, distress has seized me, and You are the Most Merciful of all those who show mercy.’ So We answered his call, and We removed the distress that was on him, and We restored his family to him (that he had lost), and the like thereof along with them, as a mercy from Ourselves and a Reminder for all who worship Us (God).” (Quran 21: 83-84)

Reading and pondering over the hardships suffered by our Prophets 'alayhimus salaam., the Sahaba Radhiyallaahu 'anhum and the Awliya ra; reflecting on the hardships suffered by those worse off than us, those with heart rending diseases, those in war torn countries, those made homeless, hungry and bereaved by natural disasters; one will be left with a firm conviction that no matter how grave one’s situation is, there is still much to be grateful for. This will help one to come to terms with one’s grief quickly and the depressing mood will not be allowed to continue. Peace will enter the heart and despair will turn to hope.

So let the tears fall but let the heart be filled with patience! With humility and submission acceptance of the decree of Allah ta'ala will bring peace.

ummtaalib · March 18, 2014

Recall the Trials of Prophets

When you are hurt by people who share blood relations with you,

Recall Yusuf (a.s) who was also betrayed by his brothers

When you find your parents opposing you in deen

Recall Ibrahim (a.s) and his father

When you are stuck in some problem and find no way out,

Recall Yunus (a.s) who was stuck in a fish's stomach

When you fall ill and your whole body cries in pain,

Recall Ayub (a.s) who was more ill than us

When you see some physical fault in yourself,

Recall Musa (a.s) who could not properly speak

When you feel lonely

Recall how Adam (a.s) would have felt when he was sent to this earth alone.

When you can't see any logic in whats going on & your heart asks why is this happening

Recall Nuh (a.s) who made the biggest ship in the desert without questioning.

SUBHANALLAH! ALLAH HU AKBAR!

Allah put all those great personalities in trials so that someday someone like you and me, if being faced by any calamity should not question, "Why Me?"

Recall the Trials of Rasoolullaah sallallaahu 'alayhi wasallam and the Sahabah/Sahaabiyaat

When you are mocked and abused by your own relatives just because you adopted deen over dunya,

Recall Rasulullah (s.a.w) who faced the same situation

When your child dies

Recall Ibraheem (r.a.) death

When your grown up children die

Recall our beloved Prophet sallallaahu 'alayhi wasallam burying two of his daughters

When your daughter is divorced

Recall our beloved Prophet sallallaahu 'alayhi wasallam having back two of his daughters

When your beloved and supportive wife (or relative) dies

Recall the loss of his wife Khadeejah (r.a.) who supported him throughout his first years of prohethood

When you're made to leave your homeland

Recall our beloved Prophet sallallaahu 'alayhi wasallam turning toward Makkah and sadly bidding it farewell when he made the Hijrah

When someone slanders you

Recall Aisha (r.a) who was also slandered through the whole city

ummtaalib · March 18, 2014

Suicide is not the Answer nor is it an Escape!

Committing Suicide (as we are all aware) is strictly forbidden in Islam and can never be justified. No matter how miserable and depressed one becomes, one must not kill oneself.

Allah Most High says:

Do not kill yourselves, for indeed Allah is Most Merciful to you. (Surah al-Nisa, V. 29)

A person, who commits suicide, does so believing it an escape from his crisis so he ends his life willing to bear a moment of pain and may throw himself of a cliff or drink a poisonous substance. Yet the following hadith shows that he actually brings upon himself that pain not just momentarily but again and again in Hell-fire.

The Messenger of Allah (Allah bless him & give him peace) said:

Whoever intentionally throws himself from a mountain and kills himself, will be in the fire (of Hell) falling down into it and abiding therein eternally forever; and whoever drinks poison and kills himself with it, he will be carrying his poison in his hand and drinking it in the fire (of Hell) wherein he will abide eternally forever; and whoever kills himself with an iron weapon, will be carrying that weapon in his hand and stabbing his abdomen with it in the fire (of Hell) wherein he will abide eternally forever. (Sahih al-Bukhari & Sahih Muslim)

The following are advices of Scholars

Impermissibility of Suicide

The following narration clearly shows the impermissibility of killing oneself even in extreme anguish and pain, for in killing oneself, one is bringing death upon one's self before Allah Almighty gives one death. Thus, it will not be permitted to commit suicide even if carried out in defence of one's honour.

Sayyiduna Jundub (Allah be pleased with him) narrates that the Messenger of Allah (Allah bless him & give him peace) said: There was amongst those before you a man who had a wound. He was in (such) anguish that he took a knife and made with it a cut in his hand, and the blood did not cease to flow till he died. Allah the Almighty said: My servant has himself forestalled me; I have forbidden him Paradise. (Sahih al-Bukhari, no. 1298 & Sahih Muslim, no. 180)

Shaykh Muhammad ibn Adam al-Kawthari

Rather than take life...

The solution to the different aggravations in life is not to take one’s life, rather, to be patient and seek assistance from Allah Ta῾āla directly. Taking one’s life is strictly prohibited. Such a person will continuously be punished after death in the same manner he had taken his life.

Thus, anyone who is in the right state of mind will not run away from the heat of the desert and throw himself into the burning fire. How can one flee from temporary hardship and difficulty which inevitably will come to an end to an eternal punishment which has no end?

Approved by Mufti Ebrahim Desai.

Suicide is the result of...

Suicide is gaining ground amongst the masses. In fact, stats show that suicide is the third leading cause of death for those aged 15 to 24.[1]

Why are the youth suicidal? What makes them entertain suicidal thoughts? In most cases, suicide is a result of one not being able to fulfil his impermissible desires and caprice. Pain engulfs the heart. Grief avalanches onto the soul. Sorrow storms onto the mind. Agony flows from the eyes. A suicidal person is incarcerated in his thoughts. He may be standing in a vast plain, yet he suffocates.

When anguish strikes the heart, it is the most critical and delicate juncture. If a person falls, he will remain fallen. Very few get up on their feet again. We have to be disciplined. We cannot be struck by the blade of agony and decide to be killed. Fight back. A limb may be lost by a blow, but look on the other side, there is still a living breathing body. There is so much more to life.

darulfiqh.com for full Q/A

Is suicide permissible under extreme circumstances?

Allah Ta῾āla is our Creator. He has granted us life and sent us to this world to test our submission to Him. During this test various conditions come upon a person.

Allah Ta῾āla says,

أَحَسِبَ النَّاسُ أَنْ يُتْرَكُوا أَنْ يَقُولُوا آمَنَّا وَهُمْ لَا يُفْتَنُونَ (2) وَلَقَدْ فَتَنَّا الَّذِينَ مِنْ قَبْلِهِمْ فَلَيَعْلَمَنَّ اللَّهُ الَّذِينَ صَدَقُوا وَلَيَعْلَمَنَّ الْكَاذِبِينَ(3)

Do people think We will leave them saying we believe and they will not be tested. Verily we have tested the people in the past so that the truthful are known and the liars are known.

(Qur῾an 29:2-3)

In another verse Allah Ta῾āla says,

وَلَنَبْلُوَنَّكُمْ بِشَيْءٍ مِنَ الْخَوْفِ وَالْجُوعِ وَنَقْصٍ مِنَ الْأَمْوَالِ وَالْأَنْفُسِ وَالثَّمَرَاتِ وَبَشِّرِ الصَّابِرِينَ (155) الَّذِينَ إِذَا أَصَابَتْهُمْ مُصِيبَةٌ قَالُوا إِنَّا لِلَّهِ وَإِنَّا إِلَيْهِ رَاجِعُونَ (156)

Verily we will test you with fear hunger and by decrease in wealth, lives and fruit crops. Glad tidings for the patient ones who at the time of adversities say, Verily we belong to Allah and to Him we return.

(Qur῾an 2:155-156)

Furthermore, Allah Ta῾āla has also promised relief after difficulties He says,

فَإِنَّ مَعَ الْعُسْرِ يُسْرًا (5) إِنَّ مَعَ الْعُسْرِ يُسْرًا (6)

Verily with every difficulty there is relief.

(Qur῾an 94:5-6)

It is narrated on the authority of Jābir ibn Samurah Radhi Allahu Anhu: A man who had killed himself with a broad arrow-head was brought to Rasulullah Sallallāhu Alayhi Wasallam and He did not pray the funeral prayer for him.[1]

The solution to the different aggravations in life is not to take one’s life, rather, to be patient and seek assistance from Allah Ta῾āla directly. Taking one’s life is strictly prohibited. Such a person will continuously be punished after death in the same manner he had taken his life.

For full Q/A

There is no Escape

Taking one’s life is strictly prohibited. Such a person will be continuously punished in the hereafter in
the manner he had taken his life. Thus, escaping from one temporary problem, he places himself into a permanent problem from where there is no escape.

Source

Do not Despair!

The common reason behind thinking of suicide is always despair. As regards the remedy of this state, we’d like also to cite the following:

“The remedy is hope. Allah made hopelessness unlawful by saying, “Do not despair of Allah's mercy.” (Yusuf: 87) Thus, no matter at what level of despair, depression and frustration we are, whether loss of a loved one or a job, or as the result of anger from someone else, we must not give up hope as there is a ray of hope at the end of the tunnel. The greatest hope is mercy from Allah.

Hope is the medicine which keeps one alive and going, which is when we say, hang on, we mean hang onto the thread of hope. It is not unnatural to be sad over situations and events. Even Prophet Muhammad, peace and blessings be upon him, used to be sad, looking at the plight of Unbelievers and their rejection of his message for Oneness of Allah, and not becoming Muslims. And Allah reminded him by saying, "Lo! thou (O Muhammad) guidest not whom thou lovest, but Allah guideth whom He will." (Al-Qasas: 56)

During dejection, there is darkness, but in hope, there is light. Therefore, one must pray for this light to illuminate the heart so that we can see beyond what is causing the suffering today. If I knew that I would not see tomorrow, I might get depressed, but the fact that I hope I will see tomorrow with all its goodness, the love of my family, my friends, dear ones, the flowers, that I go to sleep in peace, turning myself to Allah. We must pray for Allah's mercy and forgiveness so that we can love and forgive ourselves and Allah's other creations and have peace with ourselves, our Creator, and our surroundings. Source

Depression - The Medical & Islamic Perspectives

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