Anxiety, Depression Suicide and Islam

Hope, Help, Life: For the Common Good A K2 Vista Project

Anxiety is normal, unless… • Most of us feel nervous when faced with

problems or decisions at school, work or home.

• But when it gets in the way of a healthy life it can be an Anxiety disorder, which can lead to panic attacks, phobias, and more.

Stressors • School/Work Problems • Problems with Friends

• Family Problems • Medical Illness

• Losses

Actions/ Behaviors

• Withdrawal

• Decreased activity • Irritable with others

Thoughts

• Negative thoughts • Low self-esteem

• Pessimistic • Hopeless

Feelings • Sad

• Crabby • Don’t enjoy anything

• Bored

THE STRESS SPIRAL

Anxiety Solutions • Massage/Exercise • Yoga/Meditation • Diet • Drugs/Herbs • Restful Sleep • Coach/Counsellor/Professional Help

Depression • Although we all feel down at time, major

depression, are sever ongoing symptoms that impact your work, sleep, study, eat, and ability to enjoy life.

Kinds of Depression 1. Clinical depression: most common 2. Psychotic depression: which includes

depression plus disturbing false beliefs that lead to delusions and hallucinations.

3. Postpartum depression: some women experience the "baby blues“ after birth.

4. Seasonal affective disorder (SAD), affected by season during the winter months.

Bipolar disorder • Characterized by big mood swings from

highs (mania) to lows (depression).

Depression Symptoms

Holistic Depression Solutions

Natural Remedies for Depression 1. Get into a routine. Make a schedule and keep a log. 2. Set goals that are SMART and meaningful. Have

someone who will keep you honest and keep yourself challenged. Everyone needs a purpose in life, find yours, through volunteering, or part-time work.

3. Exercise. It builds feel-good chemicals called endorphins.

Even a brisk walk done regularly can work wonders.

Natural Remedies for Depression

4. Eat healthy. It is good to see a nutritionist who can customize your diet based on your health. Although the jury is out, foods with omega-3 fatty acids (Salmon) and folic acid (such as spinach and avocado) can ease depression.

5. Get quality sleep. Have a relaxation routine before you go to sleep.

This can be meditating, breathing exercises, reciting prayers. Practice good sleep hygiene, including regular times to sleep and get up (even on weekends). Avoid screen time before bed.

6. Replace negative self-talk, with positive ones. A coach can guide you

on this.

Natural Remedies for Depression

7. Supplements like Magnesium, certain vitamins and minerals can help.

Consult your doctor before taking them. 8. Practice regular duas, supplication-prayers relating to anxiety and

depression as well as reading the Quran and extra prayers. 9. Have a creative outlet. It can be gardening, photography,

scrapbooking, visiting libraries, or museums, or taking a class. There are endless possibilities. Try something new.

10. Have regular fun activities. You don't have to spend a lot of money to

enjoy simple pleasures.

The Relaxation of the Hearts

الذین آمنوا وتطمئن قلوبھم بذكر � أال بذكر � تطمئن القلوب

• Those who believe, and whose hearts find satisfaction in the remembrance of Allah: for without doubt in the remembrance of Allah do hearts find satisfaction. [13:28]

SUICIDE

Youth Suicide is the 3rd leading cause of death for Youth ages 15-24 in the U.S.

Center for Disease Control 2010

Attempted Suicides Suicides

Young 100:1

65 & over 4:1

Attempted Suicide & Age

10

• Threatening suicide

• Looking for access to means

• Talking or writing about death, dying, suicide

• Previous attempt serious enough to require hospitalization

Students at Higher Risk

22

2 females and 1 male have probably attempted suicide in the past year in a average classroom

23

Just because you are religious does not make you immune to depression and suicide.

Myth and Reality 1 • Myth: Muslims don’t

have problems of suicide, depression and other social issues of society.

• Reality: Muslims are human first and mirror to a lesser or equal degree the same social issues of society.

Myth and Reality 2 • Myth: I would know if I

was depressed. • Reality: It is hard to

self-diagnose. Most people are unaware that they are suffering.

Myth and Reality 3 • Myth: It’s my fault, my

weakness in my faith in God that I am depressed or suicidal.

• Reality: Depressed people blame themselves, their lack of faith, or that God is angry with them, when in reality they have an illness (that can be cured).

Myth and Reality 4 • Myth: I can solve my

own problems. This is a private and personal issue. It could be embarrassing, hurtful, etc.

• Reality: When your teeth hurt, you have to see a dentist, if your car is having problems you need to see a mechanic, in the same light, if you or someone you love is having emotional or mental issues they need to see a professional.

Myth and Reality 5 • Myth: The Quran and

Sunnah have all the solutions to any problem.

• Reality: Yes according to Islamic belief the Quran and Sunnah do address fundamental issues of society. However, to decode them, and to apply them in your life, you need someone who understands both mind and spirit.

Myth and Reality 6 • Myth: Religious

people don’t have spiritual and mental problems.

• Reality: Experiencing depression is perhaps more stigmatized among believers than even in the general public

Muslim teens not immune and still deal with?

Increased school pressures, academic, social

Challenge of dual identities, American and Muslim

Exploring increased independence and identity

Puberty and Hormone fluctuation

Bullying, Substance Abuse, dating

33 33

Risk Factors: Bio-Psycho-Social Biological & Psychological: • Mental Illness • Substance Abuse • Hopelessness • Impulsiveness or

Aggressiveness • Trauma/Abuse/Bullying • Major Physical Illness • Family History of Suicide • Pre-existing Vulnerability

(obese, GLBTQ, awkward, G&T …) • Previous Suicide Attempt

34

Worthless Lonely Sad

Hopeless Helpless

ACTIONS

THOUGHTS

“All of my problems will end soon” “No one can do anything to help me now” “I wish I were dead” “Everyone will be better off without me” “I won’t be needing these things anymore” “I can’t do anything right” “I can’t think straight”

Giving away possessions Withdrawal (family, friends,

school, work) Loss of interest in hobbies Abuse/use of alcohol, substances Reckless behavior Extreme mood swings

PHYSICAL

Lack of interest in appearance Changes in appetite, weight Change in sleep patterns

Desperate Angry Guilty

FEELINGS

Invitations to Help

Suicide: A lose-lose proposition • Myth: It will free me

from my problems. • Reality: Your soul will

suffer for eternity.

• Myth: My family will get over it.

• Reality: There is no closure and each family member will suffer your loss for their entire lives.

Suicide is explicitly forbidden • "And do not throw yourselves in

destruction". (Quran 2:195)

Value of Life • “…if any one slew a person - unless it be

for murder or for spreading mischief in the land - it would be as if he slew the whole people: and if any one saved a life, it would be as if he saved the life of the whole people.” (Quran 5:32)

“A LIFE SAVED”

Committing Suicide is a Major Sin (see Hadith)

• Narrated Jundab the Prophet said, "A man was inflicted with wounds and he committed suicide, and so God said: My slave has caused death on himself hurriedly, so I forbid Paradise for him.“

Bukhari Volume 2, Book 23, Number 445:

Life is given and taken only by Allah “It is He Who giveth life and who taketh it, and to Him shall ye all be brought back.” [Quran10:56]

Life is a test • Allah asks us to face challenges in life with

patience and prayer. He does not lay on us more burden than we can bear. (read last verses of Surah Baqarah)

The soul is eternal • Muslims believe that the soul is eternal,

that it never dies. It is a gift of intellect and discernment, that is, a gift of choice.

• If you take your own life, you are choosing to sin against God.

Life is a gift and a trust from God • Suicide takes away the gift of life that God

gave us, and we definitely do not condone it. The Quran says to trust God, have faith in the mercy of God, support the family, have patience, and do not destroy life.

For all of humanity, life is a struggle • There are good days and bad days, but the

Quran also reassures us that there is no shame associated with having to struggle.

Repeated torture till day of judgement • The Prophet said, "He who commits suicide

by throttling shall keep on throttling himself in the Hell Fire (forever) and he who commits suicide by stabbing himself shall keep on stabbing himself in the Hell-Fire.“

Narrated Abu Huraira:

How do we know if someone needs help?

No thoughts of harming self

Passive thoughts - “I wish I were dead,” “My family would be better off without me”

Thoughts about death, thoughts about one’s own death, thinking about suicide

Beginning to seriously consider suicide, thinking about a plan

Seriously considering suicide, developed a plan

Wants to die, has a plan, has access to method to implement plan

Choosing the Right Provider

Provide Medication Provide Counseling

Primary Care Physician (MD)

Psychiatrist

(MD)

Licensed Clinical Psychologist

(Ph.D or Psy.D) Licensed Clinical Professional Counselor

(LCPC) Licensed Clinical Social Worker

(LCSW) Licensed Marriage and Family Therapist

(LMFT)

Crisis Survival Skills: Distract with ACCEPTS

• Engage in exercise or a favorite hobby Activity • Contribute to something • Do something for someone else Contributing • Compare yourself now to past times when you

may have suffered even more Comparison • Listen to music; read books; go to movies • Be sure the event creates different emotions Emotions • Push the situation away by leaving it for a while

mentally Pushing Away • Do something to engage your mind • Count to ten. Read an engaging book Thoughts • Engage all your senses • Squeeze a ball, or ice; listen to music; dance Sensations

49

Crisis Survival Skills: Self Soothe with the Senses

50

• Look at a picture or poster that you like. Look at the stars.

• Look at nature around you. Vision • Listen to beautiful or soothing music. • Pay attention to the sounds of nature (waves,

birds, rainfall). Hearing

• Put on your favorite lotion/perfume/ cologne. Boil cinnamon. Bake. Light a scented candle. Smell

• Really taste the food you eat. • Have a good meal. Have your favorite

soothing drink (tea, hot chocolate). Taste

• Take a bubble bath or hot shower. Have a massage. Hug someone. Brush or braid your hair. Touch

Urge Surfing

Reduce

Remove

Relax

Every urge has three phases. 1. Ramp-up period begins at trigger

point or event, when the idea of doing the behavior first arises.

2. The peak is the intense high point of the urge.

3. Ramp-down or fall off period as things gradually return to baseline

TO Urge Surf: 1. Breath deep and have

willingness to reduce the urge and let go of the behavior as a solution for pain.

2. Remove yourself from the situation if you can.

3. Relax the body and practice breathing or calming techniques while staying mindful and present-focused.

51

Ramp Up

Peak Ramp down

IMPROVE the Moment • Imagine a calming and safe place • Imagine stress and anxiety draining out Imagery • Find a meaning or value to what you are suffering. • Focus on positive, growth from challenges. Meaning • Turn things over to a Higher Power • Find support, strength, or faith to cope Prayer • Use deep breathing and follow your breath • Use muscle relaxation and other ways to relax Relaxation • Focus you attention on one thing in the moment. • Keep yourself physically and mentally in present One thing…

52

ACT Abbreviation

Strategies… • Challenge negative thoughts

– Write down your worries – Create an anxiety worry period – Accept uncertainty

• Take care of yourself – Practice relaxation techniques – Adopt healthy eating habits – Exercise regularly – Get enough sleep

Things to Avoid • Don’t assume things are hopeless or will never change • Don’t engage in “emotional reasoning” (i.e.: because I

feel awful, my life is terrible) • Don’t assume responsibility for events which are outside

of your control • Don’t blame yourself for others’ feelings or behavior • Don’t use drugs or alcohol to “self-medicate”

Intervening with a depressed friend

• Be empathetic and understanding • Don’t try to “cheer up” a depressed person by minimizing

their concerns • Avoid critical or shaming statements • Empathize with feelings of sadness, grief, anger and

frustration, but… • Challenge expressions of hopelessness

Don’t

• Don’t argue about how bad things are • Don’t insist that depression or sadness are the wrong

feelings to be experiencing • Don’t become angry even though your efforts may be

resisted or rejected

Common misconceptions about Suicide

• FALSE – People who talk about suicide won’t really do it • FALSE – People who talk about or attempt suicide want

to die • FALSE – Anyone who tries to kill him/herself must be

crazy • FALSE – If a person is determined to kill him/herself,

nothing is going to stop them • FALSE – Talking about suicide may give someone the

idea

Suicide warning signs • Talking, writing, or joking about suicide or death • Giving away prized possessions • Making final arrangements • Depressive symptoms • Sudden, unexplained recovery from profound depression • Marked feelings of helplessness or hopelessness • Risk-taking behavior • Self-mutilating behavior (sometimes) • A suicide plan, letter • Significant change in behavior • Previous suicide attempts • Significant loss • Chemical (drug or alcohol) abuse

What NOT to say… • “This will make you stronger” • “Time heals all wounds” • “ I know how you feel” • “It could be worse” • “It will work itself out”

Suicide Intervention • Don’t minimize the person’s feelings or situation • Don’t leave the person alone if they have a plan and/or lethal means • Don’t use reverse psychology with suicidal people • Don’t try to be a hero – GET HELP! • Don’t promise to keep the secret – PROMISE HELP! • LISTEN, sow empathy and concern • Offer to call or talk to a parent, counselor, or other trusted adult with

them • Encourage them to get ongoing help for their depression • If they are immediately at-risk, call a suicide hotline or 911

It’s in the Shelter of Each Other…

63

• www.emorycaresforyou.emory.edu/emory_student_communities/muslim.html • Suicide Prevention for Muslim Students • www.sptsusa.org

Society for the Prevention of Teen Suicide Sponsor of this program, focuses on resources for the competent school community, including Lifelines,

an evidence-based suicide prevention program for schools. Free on-line educator training!

• www.suicidepreventionlifeline.org National Suicide Prevention Lifeline

Free confidential, 24-hour hotline, free materials

• www.sprc.org Suicide Prevention Resource Center Resources for states, on-line library, best practices registry

• www.suicidology.org American Association of Suicidology Data, resources, links, journal, national conference

• www.thetrevorproject.org/ The Trevor Project Specific information for LGBTQ youth

• www.afsp.org American Foundation for Suicide Prevention Survivor resources, research, and awareness

Web Resources

64

References • All images are from public domain • Slides 49-52: Suicide Assessment and Intervention By Mark Purcell, PsyD • Slides 53—60: www.rightsolutioncounseling.com • Adolescent Suicide: Prevalence; Circumstance; and Conditions of

Recognition, Barri Sky Faucett, MA, ASPEN Project Director • Assessment of Depression & Suicide Risk: Strategies for Matching Youths to

Optimal Interventions: Joan Rosenbaum Asarnow, Ph.D.UCLA • Working with Muslim Clients: Grief, Terminal Illness & Bereavement CBT

Interventions, Shehzi Yusaf & Wendy Sawtell • Depression and Anxiety, Understanding the Problem and the Islamic Solution

Dr. Ali Shehata, DO FACFP

This is a resource “For The Common Good” No copyright is implied, feel free to distribute.