A week before Ramadan, the Khalil Center, a U.S.-based psychological and spiritual community wellness organisation, held an online Muslim mental wellness summit in cooperation with Stanford University’s Muslims & Mental Health lab. Topics ranged from the fear of death to marital disorder and issues related to parenting. Such events usually attract a few hundred attendees, but thousands flocked to this online summit.
The high number of attendees was a signal that anxiety levels are high in the local Muslim community, said Dr. Rania Awaad, Clinical Associate Professor at the Department of Psychiatry and Behavioral Sciences at Stanford University, and clinical director of the Khalil Center in the Bay Area.
As Ramadan loomed, anxieties among American Muslims shifted to how to handle a different type of Ramadan to previous years - one under lockdown.
“Most concerns are related to isolation, with mosques and masjids closed, and that source of community, whether breaking the fast or praying, lacking for Muslims,” Awaad told Salaam Gateway.
There was also anxiety about whether fasting and different sleeping patterns could affect the immune system, and what would be religiously permissible during a Ramadan under lockdown.
Such anxieties resonate with Muslims throughout the world. In these abnormal times, mental health care professionals emphasise it is not only people with pre-existing mental health issues who are struggling to handle the COVID-19 crisis.
“Regular, everyday people are feeling sadness and anxiety. You have this anticipatory grief, from everyday losses and anticipating future losses,” said Dr Farha Abbasi, Assistant Professor, Department of Psychiatry, Muslim Mental Health at Michigan State University, USA.
“Usually we see grief and healing when an incident ends, but as this situation is long and ongoing, you will see a lot of anticipatory anxiety.”
Fear of the unknown is an anxiety producer – when will the lockdown end? What will the political and economic ramifications be from the biggest global economic downturn since World War 2? Could I or a family member contract or die from the virus?
There is seemingly such widespread anxiety that mental health professionals around the world are increasingly concerned about a surge in mental breakdowns. This extends to the health workers themselves, who have been overwhelmed by the situation.
“This is the tip of the iceberg, as there is a shortage of mental health providers (globally), and everybody needs help, including the providers - there is a big crisis in providers breaking down. One emergency response chief here couldn’t handle the pain and deaths from COVID-19, and committed suicide,” said Abbasi.
Given such a looming crisis, mental health professionals advocate retaining core religious values to get through a Ramadan under lockdown.
“For people of faith, it's important to remember that, while COVID-19 is forcing them to change lifestyles somewhat, their values still remain the same. That's a starting point for feeling together as a community and around the world despite the physical distance,” said Dr Ben Herzig, a psychologist at Kendall Psychological Associates in Cambridge, Massachusetts, USA.
Mental health professionals offer five pieces of advice:
1. TALK, LISTEN AND LEARN
“Many people, especially adults, tend to bottle up their feelings and not talk about them. Share your feelings with trusted people and confide in them. We are all vulnerable,” said Awaad.
She said Muslims should not think it is “Western or Eurocentric to talk to others about their problems”. It is not a ‘no no’, she said. Unfortunately, the modern Muslim is not always attuned to their rich heritage of healing.
Islam has a long history of holistic medicine based on spiritual, physical and mental health, which started with the early Islamic polymath Ibn Sina (Avicenna).
“Quarantine was started by Ibn Sina, who first talked about mental health, and created the first mental health asylum,” said Abbasi.
She recommends discovering how Muslims in history and the Qu’ran navigated pandemics and wars to step up to the challenges. “You can go back to religious examples, like Hazrat Yunes (the Prophet Jonah) being in the whale for 40 days,” she said.
Awaad said the enforced time at home should be considered an opportunity for learning.
“Talk to children and family about the importance of Muslim hygiene and why we wash so often. Look at what Islamic literature says about hoarding goods and price gouging. Try to re-frame the situation,” she said.
Abbasi also highlighted the need for cognitive re-framing, to think about enforced confinement in a different way.
“Think of it as a religious service, that by keeping yourself safe at home, you are keeping others safe. That is where cognitive re-framing comes in,” she said.
2. MODERATE NEWS INTAKE, SPEND TIME WITH FAMILY
“The problem with news is that it over stimulates a person, and if adults panic, then children panic. Here is an opportunity to be at home with everybody,” said Awaad.
If families are separated due to the lockdowns, virtual communication can help bridge the gap.
“Make calls to friends, virtually connect. My daughter had a virtual iftar with her friends; it is hard for teenagers to be stuck at home,” said Abbasi.
After weeks of anxiety during the lockdown, concerns can be channeled during Ramadan towards the inner, spiritual life.
“It is a perfect opportunity for praying, remembering God in all His forms, and to meditate,” said Awaad.
Many of the early Islamic polymaths engaged in the meditative practice of tafakkur, reflecting upon the universe, creation and the inner self.
“Look at how the Prophet navigated moments of crisis in his life. He would go and meditate, and come back rejuvenated,” said Abbasi.
“The Prophet would also contribute at home, cooking, washing, and playing with the children, being a role model,” she said.
4. TAKE ACTION
“People can be anxious even if there is no base line anxiety disorder. Being action orientated can help, like doing something for greater humanity, such as checking up on elders, buying groceries or giving care packages. For children this is a great way to calm anxiety, as it gives them a sense of control,” said Awaad.
Being compassionate and charitable during a Ramadan under lockdown can give a further positive boost.
“Focus on the blessings you have, and what is going well in your life rather than what is not. Be thankful and volunteer, which is a huge benefit to your mental health and integral to Islam, especially during Ramadan,” said Abbasi.
5. IF NEEDED, SEEK PROFESSIONAL HELP
“Turning inward will help most people but for some, it’s not enough. Unfortunately the rates of suicide have been on the rise, and since COVID-19 it’s been further on the rise, because of isolation and the devastation of seeing the loss of loved ones,” said Awaad.
(Reporting by Paul Cochrane; Editing by Emmy Abdul Alim firstname.lastname@example.org)
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