We currently live in uncertain and unprecedented times. As the pandemic sweeps across the world, the disruptive effects are causing widespread concern, fear and stress. These are all natural and normal reactions to the changing and uncertain situation but we need to ensure we recognize and manage the possible pandemic of mental ill health early. As the infection doesn’t discriminate, neither does its psychological impact. From infants to the elderly, professors to students, professionals to labourers, all are affected and many will be living with increased anxiety and stress1. Everyone reacts differently to stressful situations, what’s important is to be in tune with your emotions and mental well-being, and as Muslims to turn to Allah.
The symptoms of mental ill health can manifest themselves in many ways and can vary in severity. Far too often people ignore their symptoms until they are debilitating in nature, and thus more difficult to manage. It is important to be mindful of our mental health, particularly in difficult times. Our anxiety and fears should be acknowledged and not be ignored. They should be better understood and addressed as early as possible2.
One of the major challenges of these times has been the effect the media has had with the volume of news, misinformation and propaganda3. It is important to stay updated on current affairs but being inundated with information from all media outlets, including social media as well as family and friends can make it overwhelming. As a consequence many are feeling anxious in this crisis situation but not recognizing this or letting it build up unchecked can lead to more severe symptoms including fear and panic attacks. It is thus important to moderate the amount of news that is taken in and to only focus on credible sources. There have been so many well-meaning professionals who are deluded in giving “expert” advice on topics out with their specialty, and also ill meaning people who spread angst for their own pleasure while some also try to benefit financially from the uncertainty by preying on the vulnerable. It is important to ensure the information available to the public is moderated and accurate, and thus it is our duty to verify any information before spreading it and clamp down on misinformation.
To try and control the spread of the infection public spaces have gradually been closed. The impact of closing mosques locally and the gradual shutdown of major Islamic organizations around the world4 has had a profound effect on the population, both spiritually and psychologically. The loss of community can cause feelings of loneliness which fuel symptoms of anxiety and depression. That is why it is so important for the public to focus on what they can actually influence and create that community feeling in other ways. Many of the institutions have set up events online5 to benefit those who would have normally attended physically. Getting involved in helping facilitate these events contributes to the sense of community and continues to give people a purpose while isolating.
It is important to stay connected with the community and reach out to family and friends, either to talk to them or lend a listening ear, bottling it up make feelings of loneliness worse. Most people are now willing to try video calls instead of emails, phone calls instead of messages. Some even meeting up virtually for a coffee. it is important that we check on each other, particularly the most vulnerable and the elderly, and not just Muslims but people of every race, religion, and belief. Just as this virus doesn’t discriminate, neither should we. Islam teaches us about equality with the only thing separating us in the eyes of Allah being taqwa. Hierarchy is thrown out, racism, nationalism, classes, ethnicities, all socioeconomic privileges are gone in the eyes of this virus.
Parents and families will be under a great deal of stress6 with the isolation and social distancing measures as well as the lack of schooling and financial impact. There will be significant difficulty in trying to maintain a structure while working from home, looking after children and arranging time for home schooling. This may become overwhelming for some so it is important to recognize this early and take steps to remedy this.
Practically maintaining a structure would involve ensuring separate spaces are kept for work, sleep, and a separate space for relaxation & ibadah. This helps maintain a focus and to be more productive through the day. Relaxation is just as important as work when considering productivity so it is important to set aside time to do things that are enjoyable. This can be time spent with children, keeping them busy with fun activities or hobbies, or even spending time going through the seerah and other Islamic teachings.
Children are resilient but are likely to be experiencing anxiety and fear very similar to that experienced by adults. They are often very perceptive and so may very well have a fear of dying, a fear of their relatives dying or a fear of needing to go to hospital. Some may express this with irritability and anger, or may want to be closer to their parents, making more demands on them7. It is important to recognize these behaviours and respond by giving young people the love and attention that they need to resolve their concerns8. Islam teaches us the importance of the strong family structure and these difficult times highlight the need for family and friends. A human being needs to love and be loved and needs to be part of a good society.
It’s the simple things that are needed to ensure we maintain our mental health. To look after yourself and keep healthy is not only a Sunnah but also triggers feelings of positivity. By maintaining a routine, sleeping at the same time, waking up at the same time, getting ready as you normally would, we find people feel less tired, more refreshed and are able to concentrate better through the day. A personal routine helps to lessen anxiety.
There should be an emphasis on eating a healthy diet & staying hydrated as this has a direct effect on mental health9. The Prophet ﷺ enjoyed eating dates, turnip, olives and honey as some of his favourite foods. The Prophet ﷺ said, “Honey is a remedy for every illness and the Qur’an is a remedy for all illness of the mind, therefore I recommend to you both remedies, the Qur’an and honey.” [Sahih Bukhari].
Exercise is even more important now as our physical health is adversely affected by isolation measures and reduced social contact. Trying simple exercises at home is important, supported by a rapidly expanding library of online exercise videos. If able to then going out for a walk and getting fresh air & sunshine should be encouraged10.
We appreciate things more when we are restricted from them, we should reflect on the beauty of Allah’s creation all around us. One thing that this pandemic has done is give people the chance to stop. It’s given many people time that they didn’t previously have. If we waste our time or let our imagination wander then our levels of anxiety and low mood can significantly worsen11. If we spend the time to reflect, to reflect on our values, to reflect on what we want to stand for, we’ll find that we will gain meaning, purpose and direction. It is important to be able to reflect on the good around us, the good that we have achieved, the positive people around us, and being grateful for this.
It is important to be conscious of Allah in this time and engage in muraqabah. There is benefit in spending time sitting in a quiet place, clearing your mind and reflecting on Allah. Establishing a daily routine of engaging in dhikr and reciting Qur’an can be very relaxing and beneficial. If not reciting then listening to the Qur’an, but not only listening to the beauty of the voice of the qari but also the words, the un-inimitable speech of Allah.
When we are stressed and have spare time our worries can seem amplified. Allocating a time of day as a ‘worry time’ and avoiding worrying about these things the rest of the day often helps. Spend this time speaking to Allah through du’a, as in times of fear we are told to not lose hope but turn to Allah.
With the mosques closing and this pandemic projected to effect Ramadan and possibly even Hajj this year, there can be a significant impact on peoples’ sense of faith12. For those who would attend the mosque regularly, not being able to do so could exacerbate symptoms of anxiety and low mood. It is important to recognize this and ensure that they are able to maintain that connection with their faith and a connection with the religious community. Those with faith will believe that there is wisdom in whatever Allah wills even though we may not always understand it. With the understanding that Allah sends down these calamities when sin becomes prevalent and open, leading to the understanding it has not been a random act and there must be a higher power. Everything that happens is by His will so “we tie our camel and trust in Allah” [al-Tirmidhī 2517] as “nothing shall ever happen to us except what Allah has ordained for us” [Qur’an 9:51]. People rediscover their faith at times of calamity and stress. One of the most blessed wisdoms of a perceived calamity. This may very well protect them from mental ill health.
Bereavement is difficult but a normal and healthy process. Unfortunately, many who pass away from COVID-19 will have become unwell very quickly, and may very well have passed away without having their loved ones around them due to strict isolation measures. Many bereaved family members will be unable to attend the funeral due to being in isolation and the funeral may also be delayed. Islam teaches us how to deal with these difficult times. We can take comfort in that everything that happens is only by the will of Allah and so there will be wisdom in it. Remaining patient at this time is likely the most difficult thing to do but know that “Allah does not burden a soul beyond that it can bear” [Qur’an 2:286]. It is important that we look after ourselves by being even more vigilant with the measures already discussed. We should also know that spending time doing du’a and giving sadaqa on behalf of the deceased will benefit them in the afterlife in’sha’Allah, and this can still easily be done while physically isolating due to the virus. Being aware of our mental wellbeing and seeking formal help early is important as there is likely to be a higher prevalence of atypical bereavement reactions and PTSD.
These are trying times for everybody but we need to ensure that we are looking after our own mental health and that of those around us. Whether someone develops psychological injury or psychological growth from the experience will be influenced by the support they receive. Humanity will survive this pandemic, but we need to ensure we transform and grow from this rather than be damaged. Fear brings out the worst in us, we should control this, but generosity makes us think of our common survival. We should see this as a different period of time in our life, and not necessarily a bad one. We need to tackle it physically and metaphysically, ensuring we don’t observe one without the other. At the time of anxiety and fear, one of the most hopeful verses to hold onto is that “nothing shall ever happen to us except what Allah has ordained for us” [Qur’an 9:51. Many however, despite taking appropriate measures, will continue to struggle with symptoms of anxiety and depression. It is important that they seek professional help in these circumstances and it is important that we ensure that these services are available. The psychological ramifications are likely to last long after the pandemic has ended.
1- Wen Li et al Progression of Mental Health Services during the COVID-19 Outbreak in China. Int J Biol Sci 2020; 16(10):1732-1738
2- Xiang Y-T, Yang Y, Li W, Zhang L, Zhang Q. et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry 2020 Mar; 7(3):228-229
3- Gao J, Zheng P, Jia Y, Chen H, Mao Y, Chen S et al. Mental Health Problems and Social Media Exposure During COVID-19 Outbreak. SSRN Electronic Journal. 2020
4- Ahmed Q, Memish Z. The cancellation of mass gatherings (MGs)? Decision making in the time of COVID-19. Travel Medicine and Infectious Disease. 2020;101631
5- Liu S, Yang L, Zhang C, Xiang Y, Liu Z, Hu S et al. Online mental health services in China during the COVID-19 outbreak. The Lancet Psychiatry. 2020;7(4):e17-e18
6- WHO. Mental health and psychosocial considerations during the COVID-19 outbreak, 18 March 2020
7- Cluver L, Lachman J, Sherr L, Wessels I, Krug E, Rakotomalala S et al. Parenting in a time of COVID-19. The Lancet. 2020
8- Dalton L, Rapa E, Stein A. Protecting the psychological health of children through effective communication about COVID-19. The Lancet Child & Adolescent Health. 2020
9- Owen L, Corfe B. The role of diet and nutrition on mental health and wellbeing. Proceedings of the Nutrition Society. 2017;76(4):425-426
10- Howell A.J., Passmore HA. (2013) The Nature of Happiness: Nature Affiliation and Mental Well-Being. In: Keyes C. (eds) Mental Well-Being. Springer, Dordrecht
11- Zuzanek J. Time Use, Time Pressure, Personal Stress, Mental Health, and Life Satisfaction from a Life Cycle Perspective. Journal of Occupational Science. 1998;5(1):26-39
12- Abdel-Khalek A. Islam and mental health: A few speculations. Mental Health, Religion & Culture. 2011;14(2):87-92