Depression

Dear Fatima, I’m a17 year old female. I’m from Pakistan, was born in Canada but I’m currently living in the Middle East. I’m not sure where exactly to start, so I apologize if this is a bit messy as my thoughts are quite jumbled up at the moment. I’ve been struggling with some things in my life for a while now. I’ve never felt like I could talk to my parents about these things because they don’t really take mental health all that seriously. I’ve talked to friends but I felt like talking to a person more experienced – like a counselor or a therapist. The more prominent reason why I want to talk to a professional is that I need professional advice. I would say that I’m depressed. At one point I thought maybe I’m just feeling sadness so I searched up the difference between sadness and depression and this is what I got: “Sadness is a normal reaction to a loss, disappointment, problems, or other difficult situations. Feeling sad from time to time is just another part of being human. Depression is a mental illness that affects your mood, the way you understand yourself, and the way you understand and relate to things around you. Depression can come up for no reason, and it lasts for a long time. People who experience depression may feel worthless or hopeless. Some people may experience depression as anger or irritability.” I would say that I am depressed because these symptoms encapsulate exactly how I’ve been feeling for about three years now. When I was 14 my relationship with my parents, more specifically my father, started deteriorating. It seemed as though we just didn’t understand each other and my father and I could never get along. There are many reasons for this. My father is quite short-tempered and that’s one of his qualities that makes me look at him differently. He gets angry at little things and it frustrates me a lot. He’s a good Muslim and so he’s always told me to dress modestly, but every time I tried to do that he’d find things to say about my outfit: “that shirt is too short” “those pants are too tight” “don’t have your shirt tucked in” – it got to the point where I just hated going outside and I even avoided it just so my father wouldn’t criticize me. I listened to the things he said but there would always be something wrong or something he didn’t like as if nothing I did was ever good enough. Whenever we talk we always argue – it’s quite repetitive like a cycle. We both disagree on something or he makes comments about me that I don’t like, I get frustrated and then I shut myself out, then I become so frustrated with myself after I calm down because I hate the way I have the same short temper as he does as that’s the quality I hate the most but unfortunately it’s the quality I have too. During these years and to this day this is still an issue and there are other things too. I’m incredibly self-conscious about my body and I hate it. When I was little everyone would ask my mother if I even ate because of how weak and skinny I looked. Then when I was around 15 years old I started gaining weight and now I despise the way I look. I’ve tried so many things, diets, exercises, starving myself even but nothing works. These past few years have been the same – I’d restrict myself from eating certain things or I would starve myself and eventually, in a few weeks time, I would lose control and just binge eat all the things that I had been restricting and then I feel so awful and I feel like just throwing up and I hate that feeling so much and then I look at myself in the mirror and I think to myself “I look so fat and disgusting, I can’t even starve myself properly to be skinny.”

I feel worthless and pathetic. All. The. Time. I don’t even achieve good grades it stresses me out so much and I want to able to make my parents proud but in the end, I don’t feel like I’m good enough. I stress so much that it makes me binge eat, it makes me lose sleep as my thoughts keep me up all night and I believe I take out some of this stress on my family members by having random bursts of outrages and distancing myself from them. I’m in no position to self diagnose myself with depression – and I feel ashamed to even because I have friends who have been clinically diagnosed – but after reading the definition of what depression is I realized that that’s exactly how I have been feeling for the past few years. To be honest, I have had suicidal thoughts – more than once, but I know that I would never go through with it because of two reasons: I don’t want to end up in hell and I can’t ever put my family through that kind of pain. It breaks my heart when I can’t even go to my mother to talk about my struggles. Both my parents don’t take mental health seriously. I’ve harmed myself a couple of times – cutting. Recently (a month or two ago) my parents saw the scars on my arm and realized what I did and do you know how they reacted? My dad didn’t say anything. My mom got mad at me and all she said was “Why would you that? You should feel ashamed. Don’t ever do something stupid like that again.” She didn’t even ask me why I did it in the first place. She didn’t even ask me if I was okay. As I’m writing this I’m crying my eyes out. Was that not an obvious sign? That I needed some help? That I’m not doing okay? Who am I supposed to turn to for help if not them?

That’s why I’m too afraid to ask if I could even have a counselor or a therapist. I’ve felt so lonely and confused for a long long time. I’d cry at night for ours. Sometimes I sleep all day just so that I don’t have to wake up and deal with everything. Sometimes I wake up super early, when everyone else is sleeping so that I could just be alone. Sometimes I start crying without any particular reason. I feel quite guilty for feeling the way that I feel. There are millions of people out there who are dealing with bigger struggles; loss of loved ones, poverty, war, abuse and so much more. Why can’t I just be more grateful?

Even so, I dread the way I feel all the time – do you know what it’s like?

It feels like I’m drowning while everyone else around me is breathing. I feel helpless, trapped, angry at everyone’s obliviousness to how I’m feeling. My thoughts take over me like a wave and I feel like I have no control over anything. However, a part of me still wants help because I’m exhausted from feeling this way.
I hope that this made sense. Thank you for taking the time to read this.

Dear Sister,

I am so sorry for all that you are going through. I can feel the weight of your email on my chest as I read it and I can only imagine how much you are feeling. I want to first thank you for reaching out to us, it takes a lot of courage to talk about what you are going through. May Allah swt make this easy for you.

There are few things in your post that I would like to address:

I want to first make sure you are safe, and if you are having suicidal thoughts or thoughts of self-harm, such as cutting, please reach out to the following

National Suicide Prevention Lifeline 1-800-273-8255 – they also offer chat online https://suicidepreventionlifeline.org/chat/

I do think it might be worth trying to talk to your parents or at least your mother and explain to her what you are going through and would like to seek professional help. Speaking to a professional face-to-face will help you navigate some of these emotions and difficulties you are facing, They will be able to help you address your problems and regain self-confidence as well as help you remain safe and keep the thoughts of self-harm and suicide away. If your parents don’t seem like a good option or they are not supportive, maybe reach out to someone you trust in your family or community that can help in either talking to your parents or finding someone to talk to in your area.

For some people self-harm is away for people to cope with other problems that they are either aware of and are trying to suppress or already suppressed emotions or feelings. And though one may feel this is the only way to express what is going on or be able to suppress the feelings, there are other ways that can be more beneficial to you. Many people don’t know how to stop because it can form into an addiction. You need to know you are worth more, and that you can get better help. Often times, people who are not aware of what self-harm is and how it can affect one who is suffering from it, they will not understand that it is deeper than one being selfish. Some self-harm as a way of expressing emotional pain. Additionally, it might be helpful to find someone you trust that you can go to when you do feel the urge to hurt yourself, help them learn the severity of self-harm and ask them to just be there for you in those times. It is also important to understand why you self-harm so that you will have a stronger understanding to other ways to cope. Aside from therapy you can do this by journaling your thoughts. This will help you get your emotions out that you can read back and hear what it is that is troubling you. Whenever a trigger comes about you can be more prepared on how you can deal with it. Perhaps go for a run, or talk to a trusted friend, or meditate. Some other ways that can help you cope can be: Paint, draw, volunteer your time, and pray.

Remember, self-harm doesn’t occur in a vacuum. It’s an outward expression of inner pain. I have faith that you will get there. You are a strong and beautiful individual. You must remember that it is ok to breakdown every now and then, and that you can get through anything.

I am sorry your relationship with your father isn’t where you would like it to be. What you should know is you are not your father. For one, you are recognizing that you tend to react and that is a huge step in the right direction. With this self-awareness you are able to help yourself become more aware of your reactions and direct them in the way you would like to react. You can do this by practicing mindfulness. SubhanAllah our religion has mindfulness built in to its traditions. As you pray sit with Allah and create a relationship that allows you to stay in the moment. Mindfulness will help you pay attention to what you are experiencing moment by moment. When you are mindful, you are aware of your thoughts, feelings and body sensations. You notice the thoughts that are flitting through your mind and the feelings that go with them. You notice the sensations in your body. When you are mindful, you are observing what is happening around and inside you without judgment. You are both fully in your experience and slightly removed from it. You notice and accept all the thoughts, feelings and sensations you are experiencing in the moment. But you know that another fresh moment is coming that will bring other thoughts, feelings and sensations. There are some great apps that can help you with this such as ‘Calm’.

Lastly, I recommend reading about Negative Automatic Thoughts and Growth Mindset. We have thousands of thoughts every hour and many of those thoughts are automatic and negative. If we don’t pay attention to them and change their tone, they can take control of our behaviors and mood. The good news: we have the power to change those thoughts. One way to do this with negative thoughts is by practicing positive self-talk. A fun way to do this is to look in a mirror and read a script of compliments. Come up with 3 things every week that are positive, and read the list to yourself every day. Eventually, those words begin to stick and it becomes easier to get rid of negative thoughts.

My thoughts and prayers are with you. May Allah swt make it easy for you – and remember He is always there for you. And your Lord says, “Call upon Me; I will respond to you.” Quran 40:60

Sincerely,

Your sister in Islam,

“Fatima Y”

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Assalaamu Alaikum Sister: 

 

It seems as though your deteriorating relationship with your father may have triggered the initial sadness and as circumstances worsened so did your mental health. The greatest contributing factor seems to be the lack of validation of your feelings as well as not having an outlet to express them. Overtime, sadness that has been invalidated and pushed away can trigger depression, self harm, and suicidal ideation. You’re feelings are valid no matter what; moreover, your experiences do not need to be worse than someone else’s experience/situation in order for your feelings to be considered valid. 

 

Our feelings are given to us from Allah, and we have them for a reason. To keep it simple, negative feelings indicate that something is not right about our situation and that there needs to be a change. Feelings of being out of control and unresolved grief, in addition to all of your other negative feelings can also trigger eating disorders. But as you mentioned, cycling between eating and starving can further exacerbate negative feelings towards your self. Since you have little control over your parents’ behaviors do everything you can to focus on protecting yourself and spend as much time as you can around people who are supportive, validating and have a positive influence in your life. You have been holding on to a great deal of distress for a long time and I agree that seeking the help of a mental health professional will be extremely helpful for you. It takes great strength and selflessness to think about the pain your family would go through if you took your life, despite the pain and hopelessness you feel yourself. I am glad your love for your family and desire to please Allah is a source of motivation to avoid committing suicide.  I hope through your healing journey you will learn that not only are ALL of your feelings valid and acceptable, but that you are perfect and worthy of unconditional love just the way you are. 

 

Unfortunately, many of our parents do not come from cultures where seeking mental health services are common practice. They do not understand the severity of issues like depression nor the importance of seeking appropriate treatment. May Allah grant your parents the wisdom to recognize your distress and provide you with the support and professional help you need. If your parents do not agree to pay for mental health services, look into options at your school such as a school counselor, or if you plan on attending a college/university students typically have free access to counseling services as well. Due to the COVID-19 pandemic many non-profit organizations are offering free support groups and online therapy which could be a great option for you. And of course, as previously mentioned, you always have the national suicide hotline available (https://suicidepreventionlifeline.org/) as well as the crisis text line (https://www.crisistextline.org/) to turn to when you are feeling down or just need someone to talk to. May Allah make it easy for you to gain access to the help you need and grant you peace, contentment and happiness. Ameen. 

Here are some helpful links below related to depression/suicide and eating disorders:

https://www.helpguide.org/home-pages/depression.htm

https://www.helpguide.org/home-pages/eating-disorders.htm

https://www.alsana.com/helpline/

You Sister in Islam, 

“Fatima V”

Afshana Haque, PhD, LMFT-S