In the world we live in, especially in the West, we cannot avoid the topic of depression. People in today’s capitalistic and consumerist society are facing this diagnosis in accelerating numbers and are devouring medication for it. There is a need for mercy for this increasing group of brothers.
Could you aid us in how to understand this phenomenon through the lenses of the wisdom of the Dīn, and how this is interpreted in the fiqh?
In what ways can we generally make it easier for people with this sickness?
1. Can severe depression be seen as insanity and thus in some cases transform a mukallaf into a non-mukallaf? From what I have understood, depression has a wavelike pattern, with days where the afflicted person can interact with the world, society and with Allah, and other days where the afflicted person does not function normally, cannot eat properly, cannot sleep or cannot do other than sleeping, cannot handle the “burden” of meeting other people, and is also utterly unable to face the meeting with Allah in salāt. Also, women in this state have been known to take off the hijāb, something which in a normal state they would never ever do. Since it implies no denial of the obligation of either salāt or hijāb, could such a person then be deemed to be temporarily insane? In any case, an afflicted person can be in very real terms utterly unable to pray.
2. What can be said about the medicine prescribed?
In the name of Allah, the All-Merciful, the Most Merciful.
May Allah’s prayer of blessing and mercy and the salutation of peace be on His chosen Messenger, his family and the entirety of his companions, and whoever follows them by actively carrying out beneficent goodness until the Day of Judgment.
It is trite law that a person is mukallaf if he is in a legal state of mental sanity, and that he exits the circle of taklīf by its opposite, since mental insanity, in terms of declaratory law or al-hukm al-wad`ī (which is one division of al-hukm at-taklīfī), is a hindrance or māni` to the setting in of judgments and the obligation to abide by them.
Thus, insanity (junūn) at the time of the “obligatory time” of a prayer, what is termed its waqt darūrī by the jurists, is an excuse (‘udhr) exonerating an otherwise mukallaf person from the duty to perform it therein.
Insanity is the loss of rational tamyīz which impacts on the discrimination between states and actions. Unlike sleep or unconsciousness, there are “window” periods or situations where such discernment by the intellect operates unimpeded.
What you term “depression” is a loose term. Only Allah knows His junūd, His armies, and this age has produced a number of new psychological (as well as physical and psychosomatic) diseases.
I for instance knew of a person who could not make the ablution or pray at all due to his intense state of obsessive compulsive disorder (OCD).
Obsessive–compulsive disorder (OCD) is an anxiety disorder characterized by intrusive thoughts (what we call whisperings or wasâwis in the Islamic lexicon) that produce uneasiness, apprehension, fear, or worry, by repetitive behaviors aimed at reducing anxiety, or by a combination of such thoughts (obsessions) and behaviors (compulsions). Symptoms may include repetitive hand-washing, nervous habits and constant doubts as to whether one has purified a given spot of the body in ghusl or wudû’ or istinjâ’, uttered the takbîr, done any act of the prayer, etc. People affected thereby are prostrated by these symptoms. They can in fact be alienating and time-consuming, and, by sending you into a vicious spiral like a dog forever chasing its tail and causing its own body to bleed, they often cause severe emotional distress. The acts of those who have OCD may appear paranoid and come across to others as psychotic. However, OCD sufferers generally recognize their thoughts and subsequent actions as irrational, and they may become further distressed by this realization. The distress of being compelled to repeat actions they acutely know to lack a rational basis is even worse than the pain occasioned by such actions. A sufferer feels incapable of addressing Allah or confronting the world outside. Though they are painfully aware of their disorder, once they are caught in its spires they cannot rationally distinguish things. As they are unable, factually, to discriminate and take rational control of their obsessive-compulsive impulses (otherwise they are perfectly sane and generally brilliant individuals with a marked inclination to perfectionism), they lose the requirement of mental tamyīz or discrepation between things which is the fountainhead or cornerstone of legally recognized mental sanity for Islamic taklīf. Accordingly, the individual I referred to was “insane” insofar as the obligations of attaining ritual purity and performing the prayer were concerned, and such as the hajj would have fallen under the same category; though he was a mumayyiz or discerning person with regard to all other obligations, such as zakāt if applicable, fasting, correct pecuniary transactions (contracts et al), marital duties, susceptibility to be liable for delictual damages or criminal offences, and so on. It might be that a person’s OCD or some other disorder of the psyche (which is as unintended as one befalling the body) prevents him from fasting, in which event the same juristic visual angle would become applicable to such fard in his regard.
Essentially, therefore, whether the underlying medical cause happens to be some facet of depression, OCD, schizophrenia, etc, once it strips the otherwise mukallaf from the foundational ability to factually discriminate between states and actions or tamyîz, hence to be subject to taklîf, he moves juristically within the ambit of insanity or junûn to the extent that such contingent insanity affects his ability to execute a specific obligation of the Law or any cluster thereof, constantly or intermittently, periodically or suddenly. Mutatis mutandis, therefore, the same ruling applies to the entire spectrum of such situations. One must simply adjust the details peculiar to each to the specific circumstances of every such case.
Though contingently insane, one must strive to recover full taklīf as a believing adult. OCD, which befalls children and adolescents as well as adults, is the fourth-most-common mental disorder, and is diagnosed nearly as often as asthma and diabetes mellitus. In the United States, it is said that at least one in 50 adults has OCD. Italy displays similar if not worse statistics. I have noticed that in Islam it particularly handicaps people who have come into the Dīn and are students of fiqh and its like; people, that is, who take their Dīn seriously and want to be precise in everything they do about it. Their own perfectionism is a chink in their armour. It is said that there is a specific demon assigned to attack them with whisperings. They are attacked precisely because the Shaytān is jealous of them, as they are sincerely devoted to Allah. They are assailed due to their strength as Muslims. They are a threat to the Shaytān. It is well-known that the Companions were preferred targets of his vicious raids of insinuations. The experiencing of sickness in the Dīn is commensurate with the degree of a person’s commitment to it: The higher such commitment, the greater his ordeals. Since a large section of the born Muslims are already doing the work of the Shaytān by abandoning themselves with relish to whatever the kuffâr bake afresh and offer to the narcotized masses of the world, they are often spared such whisperings, given that there is hardly anything in them which the Shaytān can be bothered about or incessantly needs to work on.
Due to the aforesaid, these sufferers must be recognized as special people deserving of affectionate concern. That concern must be linked however to urging a rectification of their states. They must be wisely but forcefully induced to seek psychological treatment if they do not do that themselves (They often feel too guilty to do so, and ignorant Muslims, especially the born ones, who do not know at all how reality operates, simply increase their feeling of guilt). I am not going to comment on the issue of the medical prescription. While we are against the excesses and greed of the pharmaceutical industry, we must not elevate such as alternative medicine, naturopathy, homeopathy etc to the status of tenets of the Dīn. What should be prescribed is whatever grants a cure through Him, may He be Exalted, though in principle we feel that the more natural and less drug-based the therapy, the healthier it is.
These sufferers must also be reminded of the following:
a) If concern with living out the Dīn distances you from Allah and the primary obligation of prayer, the way such concern is expressed has a flaw and must be redefined;
b) We have not been born perfect. Allah is ash-Shakūr. He is grateful with a little of our goodness. He is the Most Merciful. WE WILL NOT ENTER THE GARDEN BY OUR DEEDS, HOWEVER TECHNICALLY SPOTLESS, but only through His Mercy;
c) Once we understand that, we cannot rely too much on our actions and their ostensible immaculateness. If we do rely on them, we have opened the door to the Shaytān assaulting us through them to the point that we have to disregard them or even accuse ourselves of kufr. One of the missives in Letters of the Darqāwī Way spreads that out beautifully. If we rely on ourselves, Allah will leave us to our selves’ “power”, and we know that our powerless selves turn against us;
d) As the Prophet, Sallallāhu ‘alayhi wa-sallam, has asserted, we must not die save with a good thought of Allah. Allah does not place a burden which a soul cannot bear. If obsession about purity, correctness in prayer etc, becomes so fastidious as to stop you from doing basic obligations, one is not attaining nearness to Him but the opposite, and obligations were only legislated for the purpose of worshipping Him. If the situation becomes what I have just described, one is having a bad thought of Allah by imaging that He is requiring you to take on a load you cannot endure. Far Exalted is He above such a thought! He does not need your sound worship, let alone does He need your self-flagellation in seeking to submit to His commands and prohibitions. Rather, He is telling you to find Him through demanding less of yourself, since there is no strength nor power save in and by Him, and through clinging more to the hope (rajâ’) in His Mercy. He wants such sufferers to recognize Him through His Beauty and not only through the back-crushing power of His Majesty in enacting the details of the Law;
e) When Sayyidunā Ādam, peace be upon him, erred, he instinctively looked at Allah’s Throne. His Throne asseverates the prevalence of His Mercy over His wrath. As Shaykh an-Nābulusī has stated, the ‘Arsh is thus mercy. ‘Ayn-Rā’-Shīn. The opposite of it is the Law, ash-Shar`, which is Shīn- Rā’-‘Ayn. The Law is rigour. It asks you to separate truth from falsehood, the lawful from the prohibited, and to outwardly judge by enforcing the former and outlawing the latter, by rewarding or forcibly castigating. That is why the self recoils from it, and why perennialists would want us to accept a false “all-inclusive religion” where there is only the gatheredness of the Reality without the rigorous and painful separation demanded by the Law. They are deviant imposters, as you cannot have Jamāl without Jalāl in this world. The sufferers from OCD, depression, etc, must always remember, on the other hand, that the rigour of His Law and His Wrath are secondary to His Mercy. That is why Ādam, peace be upon Him, made tawbah by pleading with his Lord through the intercession of His beloved, the Prophet of Mercy, Sallallāhu ‘alayhi wa-sallam. Loving him and following him is the key to exit the insanity engendered by such psychological dislocations and imbalances we have referred to in this cursory answer;
f) He, Sallallāhu ‘alayhi wa-sallam, has also told us that the Dīn is heavy, and that whoever seeks to overpower it shall be overpowered by it. We require medianness in things. The solution, therefore, does not lie in throwing out the baby of fiqh along with the dirty bath water of waswasah, but to temper the former with what we mentioned above;
g) Our Salaf severely slammed those who fell prey to whisperings, precisely because of that. Mālik’s school is particularly keen to combat whisperings and shut the door on them. So, while we recognize that these sufferers are often the gold mine of the ummah, they also need to be jolted out of their bad thought about Allah and succumbing to the demonic promptings of such bad opinion. Once they do that, they will be once again robed with comprehensive taklīf, but in such a manner that they have acquired greater knowledge of Allah and His invariable Sunnah in creation. They would have been purified and edified by the sickness Allah has mercifully decreed for them, instead of plunging into the depths of despair.
Obsession about what whisperings would like one to focus on is but a reflection of a morbid obsession with one’s self, the self-reproaching self or an-nafs al-lawwāmah which Allah has taken an oath by in Sūrah al-Qiyāmah. It is a weighty creature, as Allah does not take oaths save by what is of qualitative magnitude. That stage of the self is the battleground for reaching the inner contentment of an-nafs al-mutma’innah, about which Allah says at the end of Sūrah al-Fajr that it shall be admitted among His slaves and that it shall be admitted into His Garden, we ask Allah for such outcome for all of us so that we can gaze at His Face therein, āmīn. Such self is past the constant ordaining of evil (an-nafs al-ammārah bis-sū’: Refer to Sūrah Yūsuf in the Noble Book), but it is still fears being annihilated. From what I have learnt and noticed over the years, engagement in service to others is the best antidote to such self-obsession which the devils fuel further by their foul whisperings. Service to old, infirm and weak people is excellent, as is community service, using one’s talents for the sake of the outside world instead of viewing them as a platform to self-aggrandizement, and generally doing service to those you resent serving the most, be them your parents or whoever.