Suicidal Thoughts – how do we deal with it?

“Every soul shall taste death, and We will try you with bad and good in order to test you. Then, to Us will you be brought back.”
[The Holy Quran, Chapter 21 Verse 35]

I’m not asking for a thesis but I’ve been reading up on this for the last week on the basis of wanting to know what the answer is. Most texts I’ve read say that the believer shouldn’t be ungrateful for their life and I won’t dispute that what so ever cos life and time is a precious gift from Allah and as a result we’re accountable for it. But could it be that a person is striving to practise and yet has suicidal thoughts at the same time? To say the like of “I can’t take any more” whilst crying for help. What do people do in such situations? Where is our society heading and why would people have such thoughts?

This question keeps coming to mind time and time again, and I’m finding that I still have got some unanswered questions. In particular, is our society failing so much that we don’t recognise that people can be genuinely depressed or even upset about their situations though they are trying their best with their obedience to Allah? Is it really all down to being an ungrateful servant or is there something more to this that we need to look at? To what extent should sabr be practised before the believer finds themselves at “rock bottom” or were they already there but someone should have helped them get up earlier rather than later?

I look at the youngsters in my community and hear their upsetting news to add to this failing society we live in, and all I can think is Ya Latif! Be gentle with us and our families.

Rather than offering a helping hand here and there and listening, what else should we be doing?

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3 Responses to Suicidal Thoughts – how do we deal with it?

  1. fozia says:

    Salams Asma,

    Thanks for raising this – a very important and complex problem.

    I have a close friend, a practising Muslima, who has had depression for years, and I don’t think you could say to someone like her that being grateful to the Most High or ‘having sabr’ is the cure to her illness… there is a pathology there that needs a complex, multi-faceted approach to mirror that nature of the illness.

    I her case, cognitive therapy, plus medication (Prozac) have helped, but my view, based on seeing her experineces over the years, is that long-term therapy, with a sympathetic therapist (who need not be Muslim but needs to understand the framework we operate within) is what would really turn her thought-patterns around in more lasting way.

    Unfortunately, too many Muslims think that if you are a believer, you will be insulated from mental illness by faith itself. The truth is, as you mention above, deep faith and depression (and other mental illnesses) can and do coexist.

    Do keep us updated as to your thoughts and findings on the issue.

    JazakiLlah again, wassalam, Fozia

  2. Bismillah

    As-salamu’alaykum Habibti,

    Perhaps the following article may be of interest:

    Redefining Depression as Mere Sadness

    Let’s say a patient walks into my office and says he’s been feeling down for the past three weeks. A month ago, his fiancée left him for another man, and he feels there’s no point in going on. He has not been sleeping well, his appetite is poor and he has lost interest in nearly all of his usual activities.

    Should I give him a diagnosis of clinical depression? Or is my patient merely experiencing what the 14th-century monk Thomas à Kempis called “the proper sorrows of the soul”? The answer is more complicated than some critics of psychiatric diagnosis think.

    To these critics, psychiatry has medicalized normal sadness by failing to consider the social and emotional context in which people develop low mood — for example, after losing a job or experiencing the breakup of an important relationship. This diagnostic failure, the argument goes, has created a bogus epidemic of increasing depression.

    In their recent book “The Loss of Sadness” (Oxford, 2007), Allan V. Horwitz and Jerome C. Wakefield assert that for thousands of years, symptoms of sadness that were “with cause” were separated from those that were “without cause.” Only the latter were viewed as mental disorders.

    With the advent of modern diagnostic criteria, these authors argue, doctors were directed to ignore the context of the patient’s complaints and focus only on symptoms — poor appetite, insomnia, low energy, hopelessness and so on. The current criteria for major depression, they say, largely fail to distinguish between “abnormal” reactions caused by “internal dysfunction” and “normal sadness” brought on by external circumstances. And they blame vested interests — doctors, researchers, pharmaceutical companies — for fostering this bloated concept of depression.

    But while this increasingly popular thesis contains a kernel of truth, it conceals a bushel basket of conceptual and scientific problems.

    For one thing, if modern diagnostic criteria were converting mere sadness into clinical depression, we would expect the number of new cases of depression to be skyrocketing compared with rates in a period like the 1950s to the 1970s. But several new studies in the United States and Canada find that the incidence of serious depression has held relatively steady in recent decades.

    Second, it may seem easy to determine that someone with depressive complaints is reacting to a loss that touched off the depression. Experienced clinicians know this is rarely the case.

    Most of us can point to recent losses and disappointments in our lives, but it is not always clear that they are causally related to our becoming depressed. For example, a patient who had a stroke a month ago may appear tearful, lethargic and depressed. To critics, the so-called depression is just “normal sadness” in reaction to a terrible psychological blow. But strokes are also known to disrupt chemical pathways in the brain that directly affect mood.

    What is the “real” trigger for this patient’s depression? Perhaps it is a combination of psychological and neurological factors. In short, the notion of “reacting” to adverse life events is complex and problematic.

    Third, and perhaps most troubling, is the implication that a recent major loss makes it more likely that the person’s depressive symptoms will follow a benign and limited course, and therefore do not need medical treatment. This has never been demonstrated, to my knowledge, in any well-designed studies. And what has been demonstrated, in a study by Dr. Sidney Zisook, is that antidepressants may help patients with major depressive symptoms occurring just after the death of a loved one.

    Yes, most psychiatrists would concede that in the space of a brief “managed care” appointment, it’s very hard to understand much about the context of the patient’s depressive complaints. And yes, under such conditions, some doctors are tempted to write that prescription for Prozac or Zoloft and move on to the next patient.

    But the vexing issue of when bereavement or sadness becomes a disorder, and how it should be treated, requires much more study. Most psychiatrists believe that undertreatment of severe depression is a more pressing problem than overtreatment of “normal sadness.” Until solid research persuades me otherwise, I will most likely see people like my jilted patient as clinically depressed, not just “normally sad” — and I will provide him with whatever psychiatric treatment he needs to feel better.

    Ronald Pies is a professor of psychiatry at Tufts and SUNY Upstate Medical Center in Syracuse.

    And Allah knows best.
    Much love was-salam

  3. asmakarif says:

    Wa alaykum asalaam wa rahmatullah Fozia and Annisa,

    You are right, it is a very complex condition/situation/problem. A lot to reflect on here. Thank you for your comments.

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