Mental illness Dr Iram Sattar GP

Aims Myth busting What does Islam say about mental illness? Types of mental health problems Causes Treatment What can you do to help someone with mental illness? Where to turn for help? What can we do as a Muslim community? Useful Resources

A little Quiz...

Timings 2.00 Prayers 2.15 Introduction 2.30 Quiz 2.40 Mental illness – causes, types 3.10 - 3.20 Group work – Impact of Mental Illness 3.20 - 3.30 Break 3.30 Treatment, how to help someone, Jinn 3.50 - 4.10 Group work – What can Muslim community do? 4.20 Q&A 4.30 End

What is ‘Mental Health’? Being mentally healthy isn’t just not having a mental health problem. Good mental health: Make the most of your potential Cope with life Play a full part in your family, workplace, community and among friends Also called ‘Emotional health’ or ‘Well-being’ We all have times when we feel down or stressed or frightened. Most of the time those feelings pass. Everyone is different. You may bounce back from a setback while someone else may feel weighed down by it for a long time. 1. But sometimes they develop into a more serious problem.

Mental illness and Islam All diseases are trial and test from Allah Sins are forgiven Abu Hurayrah narrates that The Prophet pbuh said: “There is no disease that Allah has created, except that He also has created its remedy.” (Bukhari 7.582) Usamah ibn Shuraik narrated: “… ‘O Allah’s Messenger! Should we seek medical treatment for our illnesses?’ He replied: ‘Yes, you should seek medical treatment, because Allah, the Exalted, has let no disease exist without providing for its cure, except for one ailment, namely, old age’.” (Tirmidhi) To seek treatment!

Mental illness and Islam Amber Haque (2004), "Psychology from Islamic Perspective: Contributions of Early Muslim Scholars and Challenges to Contemporary Muslim Psychologists", Journal of Religion and Health Abu Zayd Al-Balkhi (850-934) Described several types of mental illness Criticised medical doctors for ignoring the psychological aspect of disease Advocated psychotherapy Ibn Sina (980-1037)

Myth 1 – “not a real disease” MYTH: Mental illness is caused by weakness rather than a medical disorder. Psychiatric disorders are not true medical illnesses like heart disease and diabetes. People who have a mental illness are just "crazy”. FACT: It is a medical condition that disrupts a person’s thinking, feeling, mood, and ability to relate to others and daily functioning. Research shows there are genetic and biological causes for psychiatric disorders, and they can be treated effectively. (Imbalance of neurotransmitters).

Causes of Mental illness Genetic – family history Small increased risk, most people do not have family members affected Stressors – past and present Difficult family background e.g. abuse - sexual, domestic violence, emotional, physical, financial, torture, etc. Stressful life events e.g. work, family, marriage, bereavement, relationship difficulties, financial, abuse, etc. Physical illness – head injury, long-term physical illness, epilepsy Long term substance abuse Social problems - poverty, domestic violence, isolation, poor housing and addiction

Myth 2 – “addiction is your own fault” MYTH: Addiction is a lifestyle choice and shows a lack of willpower. People with a substance abuse problem are morally weak or "bad" FACT: Addiction is a disease that generally results from changes in brain chemistry. It has nothing to do with being a "bad" person

Types of Mental illness Depression Anxiety Schizophrenia Obsessive Compulsive Disorder Eating Disorders – Anorexia, Bulimia Bipolar Disorder

Depression Common Lowers your mood Feel hopeless, worthless, unmotivated, exhausted Affects sleep, appetite, libido, self-esteem Tearful Mild, moderate, severe Self-harm, suicidal thoughts Anxiety and Depression are most common mental health problems

Anxiety Common Constant unrealistic worry about any aspect of daily life Restless, sleeping problems, increased heart beat, stomach upset, feeling shaky, muscle tension (headaches) Panic attacks Phobias

Schizophrenia Hearing voices and/or seeing (hallucinations) and believing (delusions) things other people don’t share and that are abnormal for your context Confusion re thoughts, withdrawn, suspicious of others Reluctant to believe help needed Up to 4% of population hear voices – most have no problem Thought insertion, thought withdrawal, thought broadcast Voices – 1 or more, familiar or not, friendly or critical Gandhi, Anthony Hopkins, John Forbes Nash (Nobel peace prize 1994, film- A Beautiful Mind), Charles Dickens, Winston Churchill, Sigmund Freud

Obsessive Compulsive Disorder Obsessions – repeated unwelcome thoughts, ideas, urges e.g. contaminated by dirt/germs worrying that you haven’t locked the door Compulsions – repetitive activities that you feel you have to do a set number of times. Obsessions interrupts your thoughts and concentration on work – feel anxious Compulsions takes up time and relief is short lived

Eating Disorders Eating too much or too little Anorexia – lose weight To feel control Bulimia – More common. Weight is steady. Binge, vomiting, laxatives Constantly thinking about food, weight, self-image To disguise emotional pain, deeper issues 1 in 20 women

Bipolar Disorder (Manic Depression) Extreme swings in mood Mania – overactive, excited behaviour, euphoria Depression Hearing voices and/or seeing (hallucinations) and believing (delusions) things other people don’t share and that are abnormal for your context

Impact of Mental illness Time to use your brain! Individual Family Society Other

Myth 3 – “pull yourself together” MYTH: If you have a mental illness, you can will it away. Being treated for a psychiatric disorder means an individual has in some way "failed" or is weak. FACT: A serious mental illness cannot be willed away. Ignoring the problem does not make it go away, either. It takes courage to seek professional help.

Treatment SUPPORT Exercise Relaxation – music, art, reading , walking, resting Talking therapies Cognitive Behaviour Therapy (CBT) Counselling Psychotherapy Group therapy Islamic Counselling Relationship or family therapy Medication Minor tranquillisers or sleeping pills – to help someone calm down or sleep Anti-depressants – to lift depression and anxiety Anti-psychotics – to control disturbing thoughts Mood stabilisers – to control extremes of mood

What can you do to help someone with a mental illness? You don’t need to be an expert to help! TALK – Don’t be afraid to ask how they are. They may want to talk about it or not. To let them know they don’t need to avoid the issue with you. ASK – how can I help? Accompany to appointment. Exercise together. Help with shopping. Be open-minded and LISTEN. Talk about other things you would normally talk about too. Learn about the mental health problem Look after yourself Emergency – A+E, Samaritan’s helpline, NHS 111 Non-emergency – leaflets, helpline, talking

Jinn related illness Jinn mentioned in the Quran – made of smokeless fire, have free will, accountable for actions, can change form, have families, eat, die Most scholars believe jinn possession is possible; some don’t 80-90% of those who think jinn related illness are wrong. Possession is even more rare. Ruqya – recites verses from Quran Patient will experience seizure and the jinn will speak through the client. No seizure occurs, but signs indicate that jinn caused the problem and is now gone. Nothing happens, in which case the problem was physiological or psychological.

What can we as a Muslim community do to help those with mental illness? Discuss... Individuals Society, mosques Work Home Friends, family Government Etc.

Resources www.mind.org.uk www.mentalhealth.org.uk www.rethink.org www.patient.co.uk www.nhs.uk www.samaritans.org - 24hr helpline: 08457 90 90 90 www.myh.org.uk – 0808 808 2008

Resources - videos www.talkingfromtheheart.org Videos in Somali, Urdu, Bengali/Sylheti www.healthtalkonline.org/mental_health/mentalhealthserviceusers Videos and transcripts of people's experience with having a mental health problem. Also of parents, siblings, carers. www.youthhealthtalk.org/Young_people_depression_and_low_mood/People/Interview/2040/Category/426 Videos and transcript of Sara (Muslim), aged 20, talking about her mental health problems and the stigma she faced from her family. They are 10-15mins long each and the Somali video has a patient talking about her mental health problems. They also contain an Imam and health professionals in each of the 3 videos. Healthtalkonline.org is a great resource with people's stories about a whole range of health problems. Youthhealthtalk.org is a great resource with young people's stories about a range of health problems

Questions Is there a link between Domestic Violence and mental health concerning both women and their children, particularly in adulthood? A woman runs a social support group, one of the stakeholders presents to her that she has frequent and numerous suicidal thoughts. She doesn't appear to be an immediate danger to herself or anyone else. In such a circumstance, what do you recommend she does in response?

Thank you! iramsattar@hotmail.com www.mwnuk.co.uk