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How Ramadan Forces Two Very Different Generations of Muslim Men to Confront Depression

During the weeks leading up to Ramadan, the Islamic holy month in which Muslims customarily fast from sunrise to sunset, Aatif Khan’s friends and family send him a variety of messages, GIFs and motivational memes celebrating its arrival. Sometimes, the memes will simply read “Ramadan Mubarak” (a greeting that roughly means “Happy Ramadan”), with captions of Arabic text from the Quran. More often, however, he’ll receive messages telling him how much they’re looking forward to fasting, or how the sacrifice of giving up food and water for more than 14 hours each day will “strengthen their imaan (belief)” and bring them closer to Allah.

“They’re well-intentioned messages,” says Khan, who describes himself as a devout, practicing Muslim. “But when I see them, I don’t feel enthusiastic about it. I feel a sense of dread and like I’ve already failed before I’ve started.”

He understands the good intentions behind these messages, but as someone who suffers from depression and spent much of his early 20s on powerful antidepressants, the challenge of fasting during Ramadan isn’t limited to hunger and thirst. It’s also 30 days of reckoning with his own mental illnesses in a British-Pakistani community where depression still isn’t fully understood, especially among men.

“There are articles online about fasting and managing all that during Ramadan,” Khan tells me. “But most of those articles are targeted at women. A lot of that is because the conversation about mental health and wellbeing is much more active among women in our communities; men still keep quiet about it.”

He adds that he can’t remember a sermon during Friday prayers that’s addressed issues around mental health. Moreover, even when imams, who lead Muslim congregations across the world, address issues like depression and anxiety, it’s often referred to as “sadness,” which is presented as curable. “Often they’ll just say that when you’re depressed, it’s a sign that you need to come closer to Allah by praying more. That’s usually where the topic ends, so it’s confusing, especially when your mental health is having a direct impact on your ability to be closer to Allah and the Deen [Islamic way of life].”

Ramadan puts him in a particularly difficult situation. In theory, because having an illness exempts one from fasting — though most available guidelines tend to relate to physical health and tend to be for the elderly — he could forego it. But Khan is 28-years-old and in “decent enough” shape. He rarely takes antidepressants anymore, instead opting for regular therapy sessions with the U.K.’s National Health Service. “So most people would say that fasting is still wajib [obligatory] for me,” he says. “Choosing not to fast then would affect me psychologically. It would make me feel like I’m disobeying my lord, and not fulfilling the basic obligations required to be a Muslim.”

Khan isn’t sure how many men go through something similar. For a brief period, he was a member of various Facebook groups specifically for Muslim men — e.g., the now defunct Muslim Men’s Discussion Forum, which last year had more than 5,000 members from around the world. Mental health was a frequent topic of conversation. “I know there are plenty of Muslim men who probably have similar challenges,” he says. “What I found was that there was a reluctance to interrogate it. A lot of that came down to things like distrust of mental-health services, or horror stories about how standard services for treating mental-health patients were often culturally insensitive, and didn’t understand cultures or people who were religious, something that I can definitely vouch for.”

This lack of trust in Western mental-health services has resulted in a number of Islamic charities (namely, the Muslim Youth Helpline, Together-UK and the Muslim Counsellor and Psychotherapist Network) expanding their mental-health outreach projects. And recently, Inspirited Minds, a faith-based voluntary mental-health charity started in 2014, launched a program designed to train imams in mental-health awareness and management, in the hope that they can identify congregants who may be suffering.

“Mental-health awareness is going up across the U.K., so it makes sense that conversations are happening in Muslim communities, too,” says Dr. Yasin Othman, a London-based private medical consultant specializing in neuroscience and cognitive behavior. “Muslim men are less likely to talk about their mental health for the same reasons that other men are reluctant to — they don’t want to show weakness; they don’t want to show their vulnerability; and so on. Also, there’s a generational issue. Muslim men from older generations, who came to the West as refugees or as low-paid migrant workers, had to provide for their families, their communities and so on. As such, their mindset is that their own health is secondary to the wellbeing of their wives and children. It also means that the conversation around mental health has been placed on second- and third-generation children, who are more educated and have been raised to think more about their own health.”

Othman says this mindset is especially relevant to rituals like fasting during Ramadan. “You’re encouraged not to think about yourself because you’re surrounded by your family and your community,” he explains. “Plus, many men know they have to provide the food for their families to break their fast with. They also know it’s a month where obligations to God come before themselves, which can mean that while they’re aware they aren’t in the best mental state, they’re willing to deal with it for the sake of their worship.”

The implication, of course, is that the terms of worship need to change — i.e., mental illnesses such as depression and anxiety should be included as exemptions for fasting during Ramadan. But while the realization is there, implementing it will likely take more time. “It’s only in the latest generation that society itself has taken mental illness seriously,” Othman says. “As a result, those suffering still might just view it as a test from God, or a test of their spiritual strength. More conversations need to take place to make sure that mental illnesses are taken as seriously as physical ones — both in society and in religious buildings.”

When I next speak to Khan, it’s the second day of Ramadan, and he’s just finished his Friday prayers. He is fasting, but he’s working with his therapist to ensure he’s not pushing himself unncessarily. He’s also made another change, which he hopes will make his Ramadan more fulfilling. “I’ve deleted my WhatsApp for the month,” he says. “Ultimately, this Ramadan is about me coming closer to Allah, knowing that he understands my struggles. He’s much more forgiving than those ‘motivational’ WhatsApp messages from family and friends.”