RELIGION AND DEPRESSION: A

PHENOMENOLOGICAL STUDY OF THE

LIVED EXPERIENCES OF MUSLIM

SURVIVORS OF DEPRESSION

BY

IS-HAAQ LEKGANYA

A dissertation submitted in partial fulfilment of

the requirements for the degree of Master of

Education

Institute of Education

International Islamic University

Malaysia

DECEMBER 2008

ii

ABSTRACT

It has been established that cultural meanings, religious practices and beliefs influence

the experience and the consequences of health and illness. Major problem that

currently exists is the lack of studies on Muslims in general and their mental health in

particular. The present study addresses this issue, focusing on the experience of

depression among Muslims. It considers the causes of depression based on Muslims’

experiences, how they experience it, and how they cope with it. In-depth interviews

were conducted with 9 Muslim participants who have experienced and recovered from

depression. A phenomenological analysis of the data indicated that among the causes

of depression among Muslim are; family/marital conflict, devoid of love and

belonging, social adversity, environmental hazard, behavioral misconduct, personal

loss and trials in life. Furthermore, the study indicated that family and religion can

either be useful means of overcoming depression or a source of initiating and feeding

depression. Participants mentioned that during the depression they experienced

fatigue, physical deterioration and self hate. Some went to the extent of despairing

from Allah’s mercy and attempting suicide. After going through these experiences,

they narrated that their recovery started from within, incorporating hope, believe,

finding a confiding relationship and religious practices. All these can suggest a model

for counseling Muslim patients and clients who are experiencing depression.

According to this model, recovery is a combination of interventions. Muslims find

solutions to their suffering and recovery through reading, understanding and accepting

the teachings of the Qur’an and the Sunnah. The major findings of this study

emphasized that employing religious teachings in recovery should be preceded by and

always go hand-in-hand with positivity and hope.

iii

ملخص البحث

الدراسات الماضية أنّ المعاني الثقافية والممارسات الدينية والمعتقدات تؤثر على تجارب ونتائج الصحة لقد أثبتت

. والمشكلة الرئيسية القائمة حالياً هي قلة الدراسات حول المسلمين عامة، وحول صحتهم العقلية خاصة. والمرض

تتركّز هذه الدراسة على . وضوع، وقد بدئت بدراسة الاكتئاب بين المسلمينوتتطرق الدراسة الحالية إلى هذا الم

ماهي أسباب الاكتئاب على أساس تجارب المسلمين؟ كيف هي تجربة المسلمين مع الاكتئاب؟ وكيف : الأسئلة الآتية

اركين مسلمين تتكون من تسعة مش يتعامل المسلمون مع الاكتئاب؟ وقد أُجريت دراسة هذه الظاهرة على عينة

المعطيات التحليلية أظهرت أن أسباب الاكتئاب بين المسلمين يمكن . الذين عانوا من الاكتئاب، و من ثمَّ شفوا منه

الحياة الأسرية غير المستقرة، التي فيها المشاكل والإضطرابات، الحرمان من الحب، والشعور بعدم : تلخيصها كالآتي

بالذنوب والمعاصي، والتعرض لنوائب الدهر، إضافة إلى ذلك نبهت الدراسة إلى أن الانتماء، العيش في حياة مليئة

الأسرة والدين يمكن أن يكونا عاملين في التغلّب على ظاهرة الاكتئاب، أو أن يكونا مصدرين في تغذية وجلب هذا

تتمثل في الشعور بالتعب، والإرهاق هذه العوامل التي سببت الاكتئاب دفعت الأفراد إلى أدنى تجربة والتي . الاكتئاب

بعد طرح . البدني، وكراهية الذّات، وإلى أقصى تجربة والتي تتمثل في اليأس، والقنوط من رحمة االله، ومحاولة الانتحار

هذه التجارب حكى المشاركون في هذه الدراسة عن كيفية شفائهم من تحديات هذا الاكتئاب الذي يبدأ من

التحلّي بروح الأمل، وإيجاد الصداقة المبنية على الثقة والمماراسات الدينية، وكل هذه الحلول إرادام الداخلية، و

يمكن استخدامها كمنهج يطبق لعلاج مرضى المسلمين الذين يعانون من تجربة الاكتئاب، وهذا يدلّ على أنّ الشفاء

لمين يجدون حلولَ معانام من خلال قراءة وكذلك أظهرت النتائح أن المس. لمعانام هو المزج بين هذه الحلول

وفهم وقبول تعاليم القرآن والسنة، ولذلك فإنّ أهم نتائج هذه الدراسة تؤكّد على أنّ التفاؤل والأمل لابد أن يسبقا

. التعاليم الدينية

iv

APPROVAL PAGE

I certify that I have supervised and read this study and that in my opinion, it conforms

to acceptable standards of scholarly presentation and is fully adequate, in scope and

quality, as a dissertation for the degree of Master of Education

.............................................

Ssekamanya Siraje Abdallah

Supervisor

I certify that I have read this study and that in my opinion it conforms to acceptable

standards of scholarly presentation and is fully adequate, in scope and quality, as a

dissertation for the degree of Master of Education

………………..........................

Nik Suryani Nik Abd Rahman

Examiner

This dissertation was submitted to the Institute of Education and is accepted as a

partial fulfilment of the requirements for the degree of Master of Education

...................................................

Nik Ahmad Hisham Ismail

Director, Institute of Education

v

DECLARATION

I hereby declare that this dissertation is the result of my own investigations, except

where otherwise stated. I also declare that it has not been previously or concurrently

submitted as a whole for any other degrees at IIUM or other institutions.

Is-haaq Lekganya

Signature …………………… Date……………………

vi

INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA

DECLARATION OF COPYRIGHT AND

AFFIRMATION OF FAIR USE OF UNPUBLISHED

RESEARCH

Copyright © 2008 by Is-haaq Lekganya. All rights reserved.

RELIGION AND DEPRESSION: A PHENOMENOLOGICAL STUDY OF

THE LIVED EXPERIENCES OF MUSLIM SURVIVORS OF

DEPRESSION

No part of this unpublished research may be reproduced, stored in a retrieval

system, or transmitted, in any form or by any means, electronic, mechanical,

photocopying, recording or otherwise without prior written permission of the

copyright holder except as provided below.

1. Any material contained in or derived from this unpublished research may

only be used by others in their writing with due acknowledgement.

2. IIUM or its library will have the right to make and transmit copies (print or

electronic) for institutional and academic purposes.

3. The IIUM library will have the right to make, store in a retrieval system

and supply copies of this unpublished research if requested by other

universities and research libraries.

Affirmed by Is-haaq Lekganya

………………………… ………………………………

Signature Date

vii

To my beloved mother

For your unimaginable life sacrifice that you presented, for the concern that

inculcated steadfastness and for the wisdom you have taught me. I thank you

whole heartedly. May Allah bless you and reward you abundantly in this life

and hereafter.

viii

ACKNOWLEDGEMENTS

All praise and gratitude befitting the Magnificence Presence and Great Sovereignty

are due to Allah, peace and salutations be upon our beloved prophet Muhammad.

I wish to say a very special “thank you” to all the participants in this study. They

taught me about their courage, the wisdom and the triumph of the human spirit. They

have expanded my consciousness and helped me to see the beauty of life.

This study would have not been excellently achieved without the intellectual

contribution and support of my supervisor, Dr. Ssekamanya Siraje Abdallah. Above

all and the most needed, he provided me unflinching encouragement and support in

various ways, most especially with his noble patience and knowledge. Throughout, his

sincere stimulating suggestions and encouragement helped me in writing this thesis. I

offer my sincerest gratitude to him.

I gratefully acknowledge Dr. Nik Suryani Nik Abd Rahman for her advices, guide,

and crucial contribution, which made her a backbone of this thesis. Her involvement

with her originality has triggered and nourished my intellectual maturity towards

understanding and carrying out this study.

Most importantly, I would have not gone any far without the sincere love and concern

of Mr. Muhammad Fareed Choonara, Sheikh Muhammad Mahmood and Brother

Feroze. I would like to extend my warm appreciation to them and to Africa Muslim

Agency (South Africa) and Mafikeng Muslim Community (South Africa) for

financing and supporting my education throughout my studies, ever since my high

school. Special appreciation to the directors, staff and board members of Africa

Muslim Agency and Mafikeng Muslim Community for their tremendous efforts and

support, may Allah reward and bless them in this life and the hereafter.

Many thanks to Dr Hariyati Shahrima Abdul Majid for assisting me in numerous

ways, particularly skills in handling and conducting a resourceful interview with the

participants. I am also much indebted to Mdm. Mimi Iznita Mohamed Iqbal for her

abundant contribution through sharing her knowledge with me; this was very fruitful

in shaping my ideas in writing this thesis.

In my daily exertion I have been blessed with a friendly and cheerful group of fellow

students who are helpful and memorable. I would like to acknowledge and state my

gratitude toward all of them, my friends and dear family support are received; most

especially I convey my gratefulness to Sis. Umairah Hj. Samah and her family for

their kind hospitality during my stay in Malaysia.

Finally, I would like to thank and express my gratitude to my mother for her sacrifices

in order to fundament my learning character, showing me the joy, love, care and the

intellectual pursuit ever since I was a child.

ix

TABLE OF CONTENTS

Abstract ............................................................................................................ ii

Abstract in Arabic ............................................................................................. iii

Approval Page .................................................................................................. iv

Declaration Page ............................................................................................... v

Copyright Page ................................................................................................. vi

Dedication ........................................................................................................ vii

Acknowledgements .......................................................................................... viii

Table of Contents ............................................................................................. ix

List of Tables .................................................................................................... xii

List of Figures .................................................................................................. xii

CHAPTER 1: INTRODUCTION

Background of the study .............. .......................................................... 1

Statement of the problem ........................................................................ 4

Objectives of the study ............................................................................ 6

Research questions .................................................................................. 7

Significance of the study ......................................................................... 7

CHAPTER 2: THEORETICAL FRAMEWORK AND LITERATURE

Introduction; Review of Literature ......................................................... 10

Diagnostic Criterion of Depression ........................................................ 10

Theoretical Perspective of Depression .................................................... 12

The Islamic View ........................................................................... 12

The Psychodynamic View .............................................................. 15

The Behavioral View ...................................................................... 16

Cognitive (Behavioral) Theory of Depression ................................. 17

Interpersonal Theory of Depression ................................................ 18

Biological View ............................................................................. 19

Other Views on Depression ............................................................ 20

Epidemiology and Etiology of Depression ............................................. 20

Depression and Religion ........................................................................ 23

Islam and Depression ............................................................................. 25

Summary ............................................................................................... 27

CHAPTER THREE: RESEARCH METHOD AND DESIGN

Introduction; Research Method and Design ............................................ 29

Research Methodology; Phenomenology ........................................ 29

Definition of Phenomenology ......................................................... 30

Research Design; The Stevick-Colaizzi-Keen Design ..................... 31

Research Framework ...................................................................... 32

Participants of the study .................................................................. 34

x

Validity and Reliability ................................................................... 36

The Instrument ............................................................................... 37

Data Collection ............................................................................... 38

Data Analysis and Presentation ....................................................... 39

CHAPTER FOUR: MUSLIMS’ EXPERIENCES WITH DEPRESSION

Introduction; Data analysis and Representation ...................................... 42

Causes of Depression Based on Muslims’ Lived Experiences ......... 42

Family/Marital Conflict ................................................... 43 Devoid of Love and Belonging .............................................. 44

Social Adversity ..................................................................... 45

Environmental Hazard .......................................................... 46

Behavioral Misconduct .................................................... 46

Devine Calamity .............................................................. 47

Harmful Thoughts ............................................................ 47

The Lived Experience of Depression among Muslims .................... 48

Feeling tired and physically drained ................................. 49

Thinking and seeing self as a failure,

worthless, hopeless and useless ......................................... 50

Living in the dark .............................................................. 51

Withdrawn and never had a social life ............................... 53

It will never get better ....................................................... 54

Curse to live up to destruction .......................................... 55

Punishment and Hell fire ................................................... 56

A near death experience ................................................... 57

Summary and Interpretations .......................................................... 58

CHAPTER FIVE: COPING AND RECOVERY

Introduction; Coping and Recovery ........................................................ 62

The lived Experience of Recovery from

Depression among Muslims ............................................. 62

Determination and optimism to recover ............................. 63

Confiding and Supportive relationship ............................. 65

Positive action .................................................................. 66

Re-Learning ..................................................................... 68

Looking at the positive side of the difficulty .................... 69

Understanding that recovery is gradual ............................. 70

Upholding positive perception about Allah ....................... 71

Observing religious obligations ........................................ 72

Leading a life of love and forgiving ................................. 73

Structural and Contextual Analysis ................................................. 74

Determination and optimism to recover vs.

It will never get better ...................................................... 74

Confiding and supportive relationship vs.

Withdrawn and never had a social life . ............................. 75

Positive action vs. Feeling tired and physically drained

and Thinking and seeing self as a failure, worthless,

xi

hopeless and useless ......................................................... 75

Re-learning vs. Living in the dark ..................................... 76

Looking at the positive side of the difficulty vs.

Punishment and Hell fire ................................................... 76

Understanding that recovery is gradual vs.

Curse to live up to destruction ........................................... 77

Regularly upholding positive perception about Allah vs.

A near death experience .................................................... 77

Observing religious obligations through out recovery......... 77

Leading a life of love and forgiving vs. Family/Marital

Conflict and Devoid of Love and Belonging ..................... 78

Summary and Interpretations .......................................................... 78

CHAPTER SIX: SUMMARY, DISCUSSION AND CONCLUSION

Introduction; Summary, Discussion, Recommendations & Conclusion .. 84

Summary of the study ...................................................................... 84

Discussion: Major findings and their significance to practice .......... 85

The present and previous studies .................................................... 88

Recommendations for practice ........................................................ 90

A proposed model for counseling depressed Muslims ..................... 92

Suggestions for further research ...................................................... 96

Conclusions .................................................................................... 97

BIBLIOGRAPHY ........................................................................................... 98

APPENDIX A: Significant Statements of Muslim’s Lived Experiences ............ 103

APPENDIX B: Themes and Clusters about the Lived Experiences ................... 113

APPENDIX C: Significant Statements of Muslim’s Recovery .......................... 114

APPENDIX D: Themes and Clusters about Recovering .................................... 128

APPENDIX E: Participants’ Intake Form ......................................................... 130

APPENDIX F: Interview Guide ........................................................................ 132

xii

LIST OF TABLES

Table No. Page No.

2.1 Diagnostic Criterion of Depression 11

3.1 The Participants’ Biographical Data 34

xiii

LIST OF FIGURES

Figure No. Page No.

4.1 Causes of Depression Based on Muslims’ Lived Experiences 43

4.2 A Model of the Lived Experience of Depression among Muslims 48

5.1 Steps of Recovery from Depression Based on the

Lived Experience of Depressed Muslims 63

5.2 Aisha’s Table Plan that helped her to take positive action and

to be optimistic 80

5.3 Aisha’s Self Talk card that she used to revive her self esteem 81

5.4 Aisha’s rejoicing and comforting words from having 13 miscarriage 82

6.1 A Proposed model for counseling depressed Muslims 93

1

CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

According to the World Health Organization, (2006), 5-10% of the population at any

given time is suffering from identifiable depression needing psychiatric or

psychosocial intervention. The life-time risk of developing depression is 10-20% in

females and slightly less in males. Persons under 45 years are much more likely to

suffer from depression than persons 45 years or older. This means that the illness is

more likely to affect people during their most productive years of life. It is therefore

important that deep exploration of depression should take place, especially in

respective societal system, so that congruent interventions can be generated.

In this study depression is defined according to the definition of clinical

depression found in DSM-IV where depressed mood and loss of interest in pleasurable

activities are regarded as core symptoms. Other symptoms include weight loss,

changes in appetite, disturbed sleep patterns, changes in activity levels, loss of

confidence and self-esteem, inappropriate guilt, thoughts of death, thoughts of suicide,

and diminished concentration.

Currently, most common treatments for depression, including cognitive

behavioral therapy, diet and antidepressants are not enough, and are not long-term

solutions (Murray & Fortinberry, 2002). Depression is one of the greatest problems

and killers of our time. Fortunately, there is an increased and growing concern and

appreciation for the holistic nature of human functioning. This has created an interest

2

in the spiritual dimension as it relates to depression, and finding alternative ways of

curbing this disorder, (Westgate & Charlene 1996).

Depressive feelings are experienced by all people and are a normal component

of disappointment and grief. As one of the most prevalent diseases globally and an

important cause of disability, depressive disorder is responsible for as many as one of

every five visits to primary care doctors. It occurs everywhere and affects members of

all ethnic groups. The rates of depression are increasing, and the disorder is nearly

twice as common among the poor as among the wealthy (Kleinman, 2004).

While there is some effort on the part of certain Muslim organizations to

establish counseling services that are appropriate to Muslims, formal services or

agencies tailored for the needs of Muslim clients are severely lacking (Haque, 2004).

This is because there are very few therapists who are well grounded in the Islamic

approach to treatment and also due to a lack of Muslim professionals interested in

starting such services (Haque, 2004). In addition to that, many of the studies on

religion and mental or physical health, especially depression, have been conducted in

the West. There are very few published studies about religion and health in Islamic

countries (Vagesh & Mohammadi, 2007).

In Muslim countries, it is generally the Imam (one who leads the prayer at a

mosque or a knowledgeable person of Islamic tenets) who treats mental health

problems. Unfortunately, in the context of modern society, such persons would not

qualify for counseling certification because of lack of training/education in the

modern mental health professions. Problems of broken homes, joblessness, and

discrimination, religion, and relationship issues are left untreated because many

Muslims may not feel comfortable working with secular therapists who do not

understand Muslim culture or the religious contexts of Muslim issues (Haque, 2004).

3

Currently, various patterns are found among depressed patients from many

ethnic groups, and all may report different symptoms and experiences ( Kleinman,

2004). Thus, there are few, if any, studies that focus on exploring Muslim’s

expressions of how depression is caused, how Muslims respond to depression, how it

is communicated and experienced, and what prescriptions are given in Islam for the

treatment of depression (Haque, 2004).

It has been established that cultural meanings, religious practices and beliefs

influence the experience of symptoms, the idioms used to report them, decisions about

treatment, doctor-patient interactions, the likelihood of outcomes such as suicide, and

the practices of professionals (Kleinman, 2004). Lack of knowledge about the way

Muslims’ religious beliefs, practices, culture, values and their life experiences, affects

presentation of depressive conditions and treatment processes could lead to under

diagnosed and/or misdiagnosed patients.

Because of such differing experiences with depression among non-Western

and Western cultures, clinicians cannot explicitly rely on classifications, such as the

DSM-IV-TR, for diagnosing the condition. Rather, it is imperative that clinicians

evaluate and treat depression within the cultural context of the client (Nicolas,

DeSilva, Subrebost, & Breland-Noble, 2007). Therefore, there is an urgent need that

Muslim counselors, clinicians and researchers working with linguistically diverse

Muslim populations systematically document the frequency of symptoms and

syndromes among Muslim clients and patients, and therefore develop an Islamically

and culturally appropriate diagnostic criterion, and identify effective treatments for the

presenting disorders of these clients and patients.

Lack of knowledge about the way Muslim’s life patterns affects presentation

of depressive conditions and treatment processes could lead to under diagnosed and/or

4

misdiagnosed patients (Nicolas, DeSilva, et al. 2007). With this in mind, depression

has become a growing concern of the mental health community (Vagesh &

Mohammadi, 2007). As more people are diagnosed each year with depression, the

mental health community continues to grapple with the origins and treatments of

depression (Westgate & Charlene, 1996).

STATEMENT OF THE PROBLEM

The forgoing studies show that depression is a major public health problem, yet little

is known about the views and understandings of depression held by many ethnic

groups (Lavender, Khondoker & Jones, 2004). Currently, researchers have outlined

the ways in which individuals from different cultures present with depression.

However, little research has focused on the Muslim population despite the sharp rise

in and continuing growth of the Muslim population in the last couple of decades

(Haque, 2004).

A major problem that currently exists is the lack of studies on Muslims in

general and their mental health in particular, without which it is difficult to devise

sound treatment plans. This issue becomes more complicated when mental health is

studied in relation to religion (Haque, 2004). Haque (2004) establishes that Muslim

students must also enter the human and social service professions in order to serve the

people of their own cultures. More importantly, there is a need to develop a

comprehensive conceptual understanding of the Islamic perspective on mental health

that can guide the professionals to appropriate treatment methods (Haque, 2004).

Conversely, it is also affirmed by Haque (2004), that there is still a little, if

any, research available on studies that focus on exploring Muslims’ expressions on

how depression is caused, how Muslims respond to depression, how is it

5

communicated and experienced, and what are the prescriptions given in Islam for

positive mental health and how depression it could be treated in an Islamic context.

Thus this study intends, to provide insight, understanding and solutions to this matter.

Haque recommends helping professionals to understand and conduct thorough

researches based on the culture, customs, and religious beliefs of Muslims and their

unique mental health needs in order to serve them appropriately on an equal footing

(Haque, 2004). For this purpose, this study shall explore of Muslims’ expressions

concerning the causes of the depression within their religious beliefs, their experiences

with depression.

It is therefore timely the rationalization for this study to fulfill the lacking and

recommendations of previous studies and that is to explore and describe how

depressive symptoms are conceptualized and communicated by Muslims and provide

further insight on how do Muslims understand, talk about and cope with depression

and what is perceived as effective treatment.

Another consideration, perhaps a more crucial one, is that the leading

psychotherapy treatments for depression were developed in the Western context.

Cognitive-behavioral therapy, which focuses on changing a person's thinking in order

to improve depressive symptoms, was developed for the treatment of depressed adults

in a Western society. Similarly, interpersonal psychotherapy, which focuses on

interpersonal behavior, was developed for depressed adults in a Western society

(Wagner, 2006). As a result, there is a need to create Islamic counseling approaches

for depression and their guiding ethical codes (Badri, 1979) based on Islamic values,

culture, morals, beliefs and Muslim life experiences.

In the introduction to Badri’s book (2000), Sheikh Yusuf Al-Qaradawi writes,

6

“One of the problems of the Muslim world today is that it has become

dependent on the West in all branches of modern knowledge. Although

some intellectuals claim that these disciplines are cross-cultural, they

have nevertheless become fundamentally Western in thought and

outlook, even in application, since they were initiated in the West and

cater for the Western vision of life. This state of affairs represents a

danger to the Islamic culture and its spiritual, moral and human values

which are left largely unobserved. Muslim specialists should therefore

take an independent line in the study of these discipline and adopt an

attitude of inquiry and criticism instead of passive acceptance” (pg, I).

In addition to that, Al-Qaradawi affirms that it is very crucial for the helping

professionals, such as counselors and psychologists, to explore the rich cultural

heritage of Islam and draw from the extensive resources available in the Qur’ān, the

Sunnah and the works of the outstanding Muslim scholars. That is because this will

not only provide new useful data which can help solve many problems faced in these

disciplines but, more importantly, it will reduce the materialism, fanaticism and

narrow-mindedness that some of these disciplines have acquired (Badri, 2000).

OBJECTIVES OF THE STUDY

The objective of this study is to explore the lived experience of depression among

Muslim, to identify principles, practices, values related to how depression is caused,

how Muslims respond to depression, how is it communicated and experienced, and

how Muslims cope with and overcome depression.

Specifically, the purpose of this study can be pointed out as follows;

1) To explore the lived experiences of depressed Muslims basing on their

values, beliefs and practices

2) To identify and describe how depressive symptoms are conceptualized and

communicated by Muslims who are facing depression

7

3) To identify the coping strategies employed by Muslims to overcome

depression

RESEARCH QUESTIONS

The study investigates the following questions:

1) What are the causes of depression based on Muslim experiences?

2) How do Muslims describe their experience with depression?

3) How do Muslims cope with depression?

SIGNIFICANCE OF THE STUDY

The important role that religious beliefs, practices, culture, values and life experiences

may have on perceptions of mental illness cannot be ignored (Ally & Laher, 2007).

Studying mental health conditions from a perspective other than that of the native

culture of clients may produce inaccurate findings (Nicolas, DeSilva, et al. 2007).

Although counseling and psychology literature are rich with the descriptions of

specific outcomes of depression and how it is perceived, this study is distinctive in its

systematic examination of Muslims perspective and their coping strategy, it shall

provide an understanding of the lived experiences of Muslims who had experienced

depression and generate a theoretical model for in which they coped with this

challenge, and also this may include experiences of Muslim counselors, clinicians,

Imams and psychologists in dealing Islamically with depressed Muslim clients and

patients.

According to Badri (1979) Western Psychologist put forward theories that are

today adopted in counseling, psychotherapy and other helping professions, which are

about man’s personality, motivation and behavior which are in many ways

8

contradictory to Islam. These theories and their application are adopted by Muslims,

which unfortunately leads many of them to consciously or unconsciously accept

theories and practices that are, to say at least, unsuitable for application in their

Muslim country.

However, it is important for Muslim psychologists, counselors and

psychotherapists not to rely solely on the adaptations of the existing theories. They

must develop the originality and the self confidence which will allow them to create

their own theories and approaches (Badri, 1979).

With the widespread and growing problem of depression, it is important for

counseling professionals to recognize the prevalence of the disorder and be able to

provide assistance not only to the clients they serve but to themselves when necessary.

In addition, mental health clinicians, counselors and psychologists treating depressed

patients should inquire about religious beliefs and incorporate devout faith into

treatment (Koenig, 2002). That is because religious beliefs and practices are

consistently related to greater life satisfaction, happiness, positive affect, morale, and

other indicators of well being.

It is therefore hoped that this study shall be useful to the following;

1) Clinicians, counselors and researchers working with Muslim populations

shall benefit form this study as it will inform about the symptoms of

depression as experienced by Muslims. They will learn from this study

how to provide culturally appropriate diagnostic criteria and counseling

approach. Hence the study will identify effective intervention for helping

Muslim clients who are enduring depression.

2) For the counselors and clinicians, this study holds important implications

for assessment and treatment of the spiritual part of the clients. The study

9

implies to counselors not to neglect the assessment of spiritual

functioning. Taking the religious part into consideration will communicate

to the client that this is a valid topic of discussion in the counseling

setting.

3) Counselors and clinicians shall be able to use these findings as ways to

reach out, understand, and provide effective therapeutic interventions to

Muslim.

4) Other helping professions shall obtain insight on treatment processes for

difficulties that may be experienced by Muslim clients and patients. The

information that will be provided shall benefit the helping professions to

understand depression as experienced by Muslims.

5) And finally the significance of this study is to put forward Muslims’

contribution in the present existing knowledge of counseling and

depression. That is because this study is distinctive from other studies by

systematically hoping to explore the causes, lived experiences and coping

strategies and recovery from depression among Muslim. This will be a

significant addition to the body of knowledge about depression and

religion.

10

CHAPTER TWO

THEORETICAL FRAMEWORK AND REVIEW OF

LITERATURE

INTRODUCTION

The prevalence of depression led the mental health community to undertake studies

and continues the research on depression extensively as it manifests in different forms

as a result of culture and religious doctrines. Until recently, these studies have focused

on the somatic, affective, and cognitive aspects of depression. As interest in holistic

approaches to mental health has increased, some counselors, psychologists and

researchers have begun to inquire into the spiritual aspects of depression (Westgate &

Charlene, 1996). The previous chapter presented fine points to be undertaken by this

study. This chapter begins by presenting the diagnostic criterion of depression,

followed by the theoretical perspectives of depression, epidemiology and etiology of

depression, depression and religion, and finally presents Islam and depression.

DIAGNOSTIC CRITERION OF DEPRESSION

Mental health professionals differentiate between two serious forms of depression

which are Major depressive disorder and Dysthymic disorder (Halgin & Whitbourne,

2007). According to Halgin and Whitbourne, (2007), Major Depressive Disorder

involves acute, time limited periods of depressive symptoms which are called Major

Depressive Episode made up of the following symptoms;

a. Depressed mood

b. Diminished interest or pleasure in all or most daily activities

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c. Significant unintentional weight loss or appetite decrease or increase

d. Insomnia or hypersomnia

e. Motor agitation or retardation

f. Fatigue or loss of energy

g. Feelings of worthlessness or inappropriate guilt

h. Concentration difficulty or indecisiveness

i. Recurrent thoughts of death or suicidality

Dysthymic disorder on the other hand, evolves struggling with more chronic

but less severe depression. Symptoms and duration are both considered as a distinctive

criterion for making a diagnosis of depression. Minor depression is diagnosed when

there is a presence of at least 2 symptoms out of nine, while Major depression is

diagnosed when there are at least 5 symptoms out of nine (Jon, 2006). Depression is

an illness that varies in degrees that are distinguished in levels of severity and

duration. These levels of severity and duration forms 6 diagnostic criteria of

Depression as indicated in the following table;

Table 2.1: Diagnostic Criterion of Depression

Major Depression Episode At least 2 weeks of five or more severe symptoms

Chronic Major Depression Major depression for at least 2 years

Dysthymic Disorder Symptoms less severe than major depression for at least 2

years

Double Depression Major depressive episode superimposed on dysthymic

disorder

Depressive Personality Disorder Enduring depressive personality pattern, i.e. gloomy,

pessimistic

Seasonal Effective Disorder Recurrent depressive episodes at a particular time of year

In consideration to the role of religion in depression, it is useful to

conceptualize depression as a mood disturbance that may take one of a variety of