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One of my favourite essays was written by Jamilla Hekmoun; it is titled ‘There’s No Such Thing as a Depressed Muslim’: Discussing Mental Health in the Muslim Community.
In this thought-provoking, enlightening essay, Hekmoun demystifies the myth that devout Muslims cannot be depressed; that depression is a sign of faithlessness in Islam; that a true believer will be happy with what Allah has ordained.
“I have had Muslims tell me that all I need to do is complete extra prayers to be mentally healthy,” she writes, later adding that this can be problematic because “while many Muslims see this as relaxing, and as a chance to seek comfort, for some Muslims with mental health issues, it can be a daily struggle. To find the motivation to pray – or to do anything – can be difficult when you are suffering from mental illness.”
Jamilla spoke to her local Imam about her anxiety disorder, who told her that mental health is just as important as physical and that the myth that it is linked to faithlessness is neither in line with Islamic thought and practices, nor is it historically accurate.
Because of the impact this essay has had in my life, the conversations I have had with many Muslims about mental illness as well as the numerous times I have been told that such conditions could be prayed away, I decided to speak exclusively to Muslim women about the reality of living with or combatting mental illness in conservative Nigeria.
For 22-year-old Hanan Bello*, mental health is the emotional and psychological state of a person. Before her Anxiety disorder diagnosis, Hanan told NewsWireNGR: “my heart went into full panic mode, if my phone chimed unexpectedly, or if there were too many notifications on my phone; if too much was going on on social media or on the news; or sometimes, for no reason at all.
I also woke up every morning with a heart that felt like it was summersaulting, as of it had been running the whole night, I usually had to lay on my chest during the first few minutes of waking up, waiting for my heart to normalize. Most times, it was painful, but the crazy part was that I thought that’s how it was for every human. When I realized it wasn’t normal, I thought it was a heart disease.”
It was after her first panic attack that she realized she needed help. The way her heart was beating in the morning became worse with each passing day until she had that first attack. “I was sure I was dying. There was all this air in the world, but I simply could not breathe,” she recounts. “I was fighting so hard to breathe; my chest was hurting so much. I was crying and feeling nauseous at the same time. I was trembling. It was horrible.”
Before this first panic attack, Hanan did not know that what she had was anxiety disorder because it did not come in the form of what she believed an anxiety disorder looked like, which was fear of public speaking. But after the first attack, she told her parents, who took her to see neurologist.
After the diagnosis, she was placed on antidepressants, which she had to take every day for months. She was also proactive; she studied her triggers and learnt to avoid them by turning off phone notifications, becoming more aware of the kind of content she was consuming on social media, muting trigger words on Twitter, etc.
Hanan believes that we need sensitisation and education across all sectors to create more awareness about mental health. According to her, mental health conditions should be taught in schools – from primary to university. This way, patients will not be marginalized in their communities for being “crazy.”
Maryam Abubakar* is one of such patients who was considered crazy. At 16 years old, the 20-year-old young adult from Kebbi state was diagnosed with ADHD, bipolar disorder, anxiety disorder, PTSD and mild psychosis. Although the diagnosis was given just four years ago, she believes she had had the ADHD since childhood and others have been as a result of sexual violence, traumatic events and educational failure. “I was always sad; I cried a lot; I kept overthinking. On some days, I’d completely zone out,” she told NewsWireNGR.
“I began having panic attacks; I couldn’t handle interpersonal relationships. On some days, I’d feel high and others I’d feel so low. I began hating myself, blaming myself. I had low self-esteem and no regard for myself. I slowly began being violent. I was unfocused, unreliable and extremely clumsy. I was at my rock bottom.”
She continued: “I was slowly going crazy. It was as though I was just a step from running mad. The voices in my head were so loud; I would clutch my chest in pain and wake up with heavy limbs. I began thinking about everything then I realized I just can’t be okay.” Maryam was a medical student and when ADHD and Bipolar disorder was discussed in class, her classmates gave her that “you suffer from this” look.
She withdrew from school and started self-learning about different mental illnesses and compare the symptoms with what she had. She took a test on MANI (Mentally Aware Nigerian Initiative) website, which indicated she suffered from six different mental illness conditions. She continued her research, which showed that she had ADHD, bipolar disorder, anxiety disorder, PTSD and mild psychosis and a year later, she went to see a psychologist who confirmed that she actually suffered from them. “I was at my lowest,” she told NewsWireNGR.
“I had suicidal thoughts. I began harming myself physically to take my mind off my emotional pain. I was so emotionally imbalanced I couldn’t eat, or sleep and I nearly took my life. After a suicide attempt, I just knew I needed help, and no one would help me till I voice out how I felt.”
She finally decided to help herself. She told her brother what was going on, watched YouTube videos and talk-shows about mental health, listened to people who suffered from different mental illness and searched for mental health care tips on the internet. She learnt to voice out her thoughts, to be easy on and forgive herself. She started daily journaling and learnt to accept, take care of and love herself.
Maryam believes that mental health means being in a healthy state of mind and that we, as a community, have a huge role to play helping those who suffer from mental health conditions. First, we have to normalise conversations about mental health by accepting that mental illnesses as just as valid and serious than physical; we must understand that mental health is not a spiritual problem.
Then we should learn how to accommodate and accept such patients and create safe spaces for patients to talk about their conditions, without the fear of being ridiculed, stigmatized or judged. She also believes that as a community, we need to understand the importance of mental health and take active steps towards being conscious and considerate of others. We need to create a mentally positive environment.
Creating a mentally positive environment has to do with creating safe spaces for speaking about such issues and also providing safe spaces for recovery. It is all about providing support and healing. Fatima Bala is a writer and researcher, who is also the producer and host of the Let’s Table This podcast, which tackles many issues around relationships, culture and health. In an episode, ‘The thing mental health caused’, she discusses mental health in northern Nigeria and how we can encourage people to open up about it.
She speaks about the perception and reality of living with a mental health condition – how people dismiss it as having aljanu(being possessed by jinns, spirits) and mood swings. There’s also a cultural aspect that prohibits people suffering from mental illnesses to open up about their pain – it would bring shame to their family name; people would call them mad, call them weak for not being able to handle issues that have been thrown at them, say they were not trained well enough by their parents; people would gossip.
Between August 2018 and September 2019, Human Rights Watch conducted research in Nigeria by interviewing 124 people in 28 facilities in different states and discovered that across the country, people suffering from mental illnesses are chained in different facilities and subjected to “years of unimaginable hardship and abuse.” These facilities include federal psychiatric hospitals, general state hospitals, state-owned rehabilitation centres, Islamic rehabilitation centres, traditional healing centres and Christian churches.
The complete disregard of mental health in Nigeria is atrocious, especially because – according to Dr. Ukwuori-Gisela Kalu, a consultant clinical psychologist and advocate for better mental health services in Nigeria – “the World Health Organisation (WHO) estimates that four percent of Nigerians suffer from depression.” Because of these and many other issues, it is hard to open up about mental health in northern Nigeria.
So, where do these Nigerian patients turn to, when facilities that are supposed to provide them with the best possible methods of treatment neglect them? Fatima Bala encourages people to seek counselling from professionals. It is much easier to speak to friends, but listening is never enough and not everyone has the ability to help. People need medical and psychological help, which should be readily available and encouraged.
She Writes Woman, also at the forefront of this battle, aims to give a voice to mental health in Nigeria. Hauwa Ojeifo, its Executive Director and a mental health advocate and coach, told NewsWireNGR that mental health encapsulates everything. She believes that it is not just the absence of mental health conditions, but also the way you think, feel and behave.
In 2015, Hauwa was diagnosed with Bipolar and Post Traumatic Stress Disorder (PTSD) coupled with Psychosis and Suicidal ideations. She had been going to the hospital alone but later realised she needed to find a community “where people could understand and relate to what I was going through,” she told NewsWireNGR. “I realised there was nowhere for people like me to come together in safe places and talk about our life experiences.” So, she started She Writes Woman to provide such safe space.
Hauwa describes She Writes Woman as a “movement of love, hope and support.” It offers solutions to some of the problems associated with mental health in Nigeria with the provision of a 24/7 mental health helpline and Safe Place, a monthly mental health support group held across six states. The movement led the first Africa Premier walk-in life clinic and hope visits, where it offers support to marginalised people.
Most importantly, She Writes Woman is keen on putting people with mental health conditions at the forefront of the movement, where they can lead the discussion. In light of COVID 19, She Writes Woman is in partnership with the Sunshine Series, offering two free counselling sessions for anyone whose mental health has been impacted by the global pandemic.
When asked about the narrative around mental health – that people refer to patients as “crazy” – and the role communities can play in tackling that narrative, Hauwa spoke about how that wrong stereotype has been reinforced in the media, our culture and religious institutions. But there are ways to combat it.
“We need to come together to create an open dialogue and aim to correct the misinformation surrounding mental health. We also need to people with mental health conditions on the frontline leading this conversation and giving real and personal information on mental health,” she told NewsWireNGR.
Hauwa’s is not the only Non-Governmental Organization that seeks to create a safe space for people to come and speak about their experiences. Dr. Zainab Mohammed, a 33-year-old Medical Doctor believes that “there’s no health without mental health. It affects the way we think, feel and act. Every illness affects our mental health in one way or the other.” Mental health caught her attention in medical school and when she realized that people close to her were suffering from mental illnesses and substances, she became more concerned. “I wanted to be part of the solution and help break the stigma surrounding mental health issues,” she told NewsWireNGR.
Dr. Zainab currently works with Reconnect Health Development Initiative, which aims to raise awareness and provide subsidized treatment, among other things. The organization recognizes that mental healthcare is a specialized service that is not readily available and affordable and hopes to change that. “We have quite a number of success stories,” Dr. Zainab told NewsWireNGR. “We have patients that have been successfully reintegrated back into the society and are stable on medication or in recovery from substance abuse.”
Reconnect offers several support groups for people with mental health conditions. ‘The slice’ is divided into two small groups of 10 – one for Trauma and Abuse victims and the other, for people battling with Depression and Anxiety; while ‘The Circle’ is a much larger group for everyone interested. It “enlightens and raises awareness about various mental health problems and substance abuse issues,” Dr. Zainab explained.
It also offers Tea and Talk: Trauma and Abuse (a mini tea party), Art Against Anxiety, Kick Out Suicide (a 5-aside soccer game) and Poetry for PTSD – light-hearted and exciting themes to encourage people with mental health conditions to combat their difficulties.
While patients are stigmatised in their communities and called “crazy”, Dr. Zainab challenges communities to educate themselves about mental health issues and break the stigma. “We need to understand that there’s no harm in seeking professional help; mental health practitioners work under strict confidentiality,” she told NewsWireNGR.
This blatant neglection of mental illness by the government stems, I think, from societal norms and stigmatization. People dismiss mental illness as “the work of the devil”, “un-African” or an indication of one’s lack of belief in God.
People tell you, “you are not praying hard enough” or “how can you be depressed as a Muslim, when Islam is the religion of peace?”
Jamilla Hekmoun did write that when she was at her lowest, prayer had offered her companionship because when she felt alone, she still had God to talk to and she knew He was listening. But while prayer can offer such comfort, we must also be proactive with our healing.
In writing about depression, a dear friend of mine Hauwa Shaffii Nuhu wrote, “it cannot be prayed away, in the same way that cancer or malaria cannot be prayed away.” No truer words have ever been spoken.
*Name changed to protect the identity of the interviewee.