Postpartum psychosis is a rare mental health condition that affects one or two in every 1,000 new mothers. Research suggests it is an overt presentation of bipolar disorder that coincides with hormonal shifts soon after delivery. Onset can be sudden and usually occurs 7-14 days after birth.

‘We can’t keep calling him Baby, can we?’ whispers Davy.

It’s Thursday 29th August 1985, and the cup of tea he brought me is still warm on the bedside table next to an empty plate. I’ve swallowed the last bite of jammy toast and am licking my sticky fingers. I feel loved and lucky, full of everything good, in my nest of pillows cradling the baby in the crook of my left arm. Years later I won’t remember if the morning outside our undergraduate flat in Aberystwyth was bright or overcast because in my low-lit memory the blackout curtains are always drawn, and the bedside lamp always blooms a languid glow.   

I match his whisper. ‘Ok, Daddy.’

‘So, we’ll decide tonight then – as his one-week birthday present?’ His words are a distant thrum.

About half of reported cases happen ‘out of the blue,’ to women without previous or familial history of psychiatric illness.

My gaze, like yesterday and the day before draws itself back to the baby. I brush his cheek with the back of my middle finger, watching his eyelids. They’re translucent, like mother-of-pearl, flickering with what I take to be his dreams. My mind is dull with love.

‘Jane, did you hear me?’

I nod without looking up as Davy bends to skim my bedroom hair with his lips.

‘Bye both,’ he says, then kisses his fingertip and touches it onto the baby’s cheek. ‘Don’t forget your bath’s running, Mummy.’

His words seem faraway, quieter than my thoughts and take forever to ripple through the heavy hush.

When the door closes after him I murmur, ‘I won’t,’ then gaze at the baby, watching his white toweling Babygro as it rises and falls. Eventually I haul myself up, sliding my arm out slowly so as not to move him awake then make a barrier of pillows to stop him rolling off the bed.

Symptoms often cascade rapidly and may include sufferers harboring odd beliefs, like their baby has something to do with God, or the Devil.

Next door in the white-wooden bathroom I flick on the lights and turn off the tap. I get undressed and sink into the milky water letting names float around my head, each foretelling a different future. Jimmy will be a writer. Dylan will have his own bakery in the Gothic quarter in Barcelona. Billy will be a scientist who’ll lead the research team who’ll eventually eradicate cancer. I roll the name around my mouth – Billy Bennett-Kermode – imagining my savior baby all grown up, healing the world. It’s a wonderful daydream until an upstart thought cuts through the treacle. How will you leave him when you have to go back to college? The clock is tick-tick-ticking.

The irritating thought has’ been nagging at the back of my mind for days and I’m annoyed with myself for letting it spoil my morning. I get rid of it by standing up and focusing on the here and now. I look through the steam at my hazy reflection in the cabinet mirror, shrimp pink, rippled fat with pendant breasts hanging heavy, full again already, aching fuller still, leaking at the thought of him. I step out and dry myself.

Developing symptoms may include a combination of manic or depressive behaviors, such as hearing voices or seeing things that aren’t there, (hallucinations), and believing things that are not based on reality (delusions).

A loop on the old cotton towel snags on something high up on the back of my leg. I tug it and a thread pulls loose. I’m surprised. There’s nothing sharp about me, not anymore. I run a hand into the puckered arc of my buttock and thigh, feeling for – well, I’m not sure what I’m feeling for – dry skin perhaps or maybe a splinter. My finger recoils, pricked by something sharp. I look to see as a garnet of blood forms cabochon on my fingertip. I lick it away then rifle around in the wicker drawers under the sink to find my compact mirror. I need to see what has made me bleed.

The tiny reflection is difficult to catch, impossible to see in the harsh white light. I twist to get into the right position. It casts no shadow, traps no color, but, narrowing my eyes into slits and poking out my tongue, as though that will help, I just about see it. Growing out of my soft folds, out of my curds-and-whey skin, is a thorn – almost invisible – a sharp, see-through thorn of glass.

‘Get rid of it,’ spits a monster thought.

I do as I’m told, pulling at the thorn, but it’s impossible. It isn’t on the outside stabbing in, it’s on the inside, stabbing out.

‘Snap it off,’ barks the monster thought.

I try really hard, holding my breath, but a fractal of pain, lightening hot, stops me. I try again and again but I can’t, even when I bite my lip hard to trick the pain.

Other symptoms may include panic, confusion and racing thoughts.

I scrabble around in the second drawer down. I might not be able to pull the thorn out but I can make it invisible. Nail-file in hand, I sit on the edge of the bath to reach underneath my leg, feeling my way. I run an exploratory rasp over the point. It’s painless – like filing nails. I file and file, shearing it away into sparkles that fairy-dust the floor. It takes forever and when I’m done, though it isn’t gone completely, it is blunted. I rub oil into the raw skin around it, then all over, to soften myself back to normal, soft enough to hold my baby.

The baby!

I run naked into the bedroom.

He’s sleeping exactly as I left him. The room’s exactly as I left it, burgundy curtains drawn, cup of cold tea on the bedside table. I do what I’ve done so many times over the last few days and sleepless nights, I reach out to touch him, extending my finger to check he’s breathing.

I only see it because the overhead light isn’t on. The lamplight casts a shadow at exactly the right moment just before it connects. In the place where my mother’s touch should be is a talon of glass, almost invisible, poised to slice. I freeze then focus, seeing it clearly now. It’s thicker at the bottom than the top, slightly hooked, tapering to a point. I scream. It wakes him up. He starts to cry.

Common symptoms also include paranoia and feeling useless as a mother.

I want to pick him up to sooth him calm. I need to feed him quiet to release the pressure in my breasts that nursing him would ease.

‘Don’t touch him,’ spits a monster thought, ‘you’ll hurt him, with your thorns of glass.’ So instead, I look down at his jerky kicks and desperate fists as he cries himself crimson.

‘Thorns lead to more thorns,’ growls the monster thought.

I turn my hands over, and sure enough, another crystal pin-prick is almost breaking the surface of my right palm.

‘There might be one on your breast.’ The monster thought whispers my darkest fears like they’re delicious. ‘There might be one on your nipple.’

I blink away the image that springs into my mind, my insides shriveling to nothing. The baby turns his head sideways, rooting, frantic to latch on. I hold him away from me, folding the thorn into my palm, feeling with my safe middle finger. The nipple is safe. I sigh with relief as his hard gums clamp down and we connect, then I sit rigid against the wooden headboard too afraid to move myself comfortable, trapped and stiff with a growing thirst. By the time he’s finished and sleeping safely away from me in his cot, we’ve worked out a plan, my monster and I.

‘No-one must know,’ it said, and because I was afraid, I agreed.

‘Especially Davy, he mustn’t ever know. I’m here now to help you cope, and if no-one sees them, if he doesn’t see them, no-one will ever know how dangerously, cruelly, terribly sharp you are.’

Typically, it is a family member, often the partner, who realizes something is wrong.

It’s a week later though I don’t know it. I’m scrubbing hard, sterilizing dozens of new bottles in my yellow kitchen gloves, screwing the brush round and round as hard as I can, to scour the tainted plastic.

‘Bye then,’ says Davy from behind my back. I feel him hovering, wanting to kiss me goodbye.

‘See you at teatime,’ I say in monotone, screwing harder to avoid the kiss.

‘Let him go,’ yawns the monster. ‘It’s not like you can let him anywhere near you, is it? Not with those disgusting thorns.’

‘S’pose not,’ I reply, forgetting myself, too tired to argue.

‘Did you say something?’ says Davy.

I turn and look at him like he’s mad. He makes his face expressionless to hide what he’s really thinking, then walks over to the pastel carrycot, kisses his finger and smears the dirty kiss onto Billy’s sleeping cheek.

‘Do you have to,’ I say. ‘It’s full of germs.’

‘Bye,’ he says again, hesitating at the door.

I sit down at the table seeing it all from far, far away.

‘You’d better get a-filing,’ sing-songs the monster, ‘so they’re nice and short and safe and secret.’

It is rare for mothers with postpartum psychosis to harm their babies, but the cognitive disorganization associated with the condition, often results in them being neglectful of their baby’s needs or harming themselves.

There’s a noisy silence echoing through the kitchen in the wake of the slap. Billy is wet-faced, sitting in his bouncy chair. He’s just stopped crying and is breathing-in in shocked, jerky sobs. I can hear him but not feel him. I turn and stare at the naked hands in the washing-up bowl.

Billy was crying and I was so tired, so exhausted that I hadn’t been keeping on top of things, letting myself go, letting my secrets show. An unfiled thorn had pierced the marigold latex. It had let the dirty water in. I’d snapped the gloves off and hurled them wet against the wall, screaming wild and high like the banshee I am. They’d slapped hard, trailing a watery bruise down the magnolia paint.

‘Chop it off,’ snarls the monster. ‘Chop it off – the whole bloody hand. Chop off the whole bloody useless thing,’ and I watch as it claps its leathery hands, dances on its filthy feet, its glassy talons click-tapping on the Lino, so I don’t hear Davy behind me, home early because he’s worried sick and we really have to talk. I don’t hear him reaching out to touch my shoulder.

I swing round raising my hands to slash. He takes them in his, turning them over slowly. Time stops as he kisses my sharpest point, pressing his lip to its pin-prick tip. I try to pull away and am surprised when it draws no blood. That night, whilst Billy sleeps, I let him talk to my monster, and show him all my thorns.

Current recommended treatment includes admission to specialist mother and baby units, where talking treatments and antipsychotic medication including mood stabilizers can be administered without separating mother and child.

Billy and I came home six weeks later. Not from hospital, but from Blackburn in Lancashire where my stepmother was sister on the Intensive Care Unit. She used her contacts to access outpatient treatment for me and I received better care than most could expect in 1985. Then, postpartum psychosis was still medically undescribed and there were no generally agreed symptoms or treatment plans. Writing this is the first time I’ve set my experience into the context of current understanding and I’ve been struck by what a textbook case I was. It feels empowering, normalizing, therapeutic even, and makes me appreciate how fortunate I was, getting the treatment I did. Especially so, because sadly, my treatment was good even by modern standards. Though postpartum psychosis is better understood nowadays, beds in mother and baby clinics are still few and far between and there are huge regional differences that make service provision patchy. Diagnosis is often missed or comes too late, all of which seems properly crazy because it’s such a treatable condition, a very temporary madness. Without treatment, it can last for years, interfering with a mother’s ability to connect with and care for her children, causing incalculable long-term harm to mother and child.

And then there’s the prejudice and stigma. The stigma attached to having had postnatal psychosis is as real now as it was in 1985. It makes people hide that they’ve had it, so they never talk about coming out the other side of the strange and scary rabbit hole, and never share their stories. That’s why I’m writing this, though it’s taken me thirty-two years to pluck up the courage.

That first evening back in Aber, I was feeling how lucky I’d been even without the benefit of hindsight. Everyone had finally left us in peace and I was skim-reading The Guardian at the kitchen table – pit closures in Yorkshire, the Broadwater Farm riots – not exactly uplifting, but it still felt good to be back in the real world.

Davy had brewed up and was balancing toward me carrying two teacups that rattled fragile on their bony saucers. Funny what sticks in your memory – he looked like he was tightrope walking. I put a careful finger through the handle and raised my cup, miming a toast so as not to risk the brittle china, then took the small white neuroleptic from the saucer and swallowed it with the first sip.

‘Welcome home, Mummy,’ he said.

The scars where the thorns still scratched just below the surface were almost invisible that night, not in a whimsical, happily-ever-after kind of way, but really, because they’d started to become ordinary – part of our everyday landscape – and because my monster was sleeping, sleeping like a baby.

References List

• National Childbirth Trust (n.d.) What is Postpartum Psychosis? [On-line]. Available at https://www.nct.org.uk/parenting/what-postpartum-psychosis (Accessed 28 Feb 2020).
• National Health Service (2014) Postpartum Psychosis [On-line]. Available at http://www.nhs.uk/conditions/postpartum-psychosis/Pages/Introduction.aspx (Accessed 28 February 2020).
• Postpartum Support International (n.d.) Postpartum Psychosis [On-line]. Available at http://www.postpartum.net/learn-more/postpartum-psychosis/ (Accessed 28 February 2020).
• Royal College of Psychiatrists (2014) Postpartum Psychosis: Severe mental illness after childbirth [On-line]. Available at http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/postpartumpsychosis.aspx (Accessed 28 February 2020).
• Sit, D. Rothschild, A.J. Wisner, K.L. (2006) A Review of Postpartum Psychosis [On-line]. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109493/ (Accessed 28 February 2020).
• Wikipedia (2016) Postpartum psychosis [Online]. 26 October 2016 Available at https://en.wikipedia.org/wiki/Postpartum_psychosis (Accessed 28 February 2020)

Depression can have a profound impact on a person’s psyche as their mind slowly cascades down a slippery slope towards irrationality. It can cause them to lose all sense of hope, enjoyment, and excitement in life. Activities that usually bring joy and vitality begin to feel unappealing and pointless. Family members and loved ones that normally bring happiness may instead be seen as a burden due to the corrupt lens that they are being viewed from. Life, as it is known, changes dramatically.

If a person uses some of the following sentences, then they may possibly be experiencing a state of depression: “I wouldn’t get out of bed if it weren’t for my cats.” “I go to bed, but I don’t really sleep.” “What I eat has no taste.” “I am useless. What good can I do anyway.” “I have no use for my children.” “I don’t remember how long I haven’t communicated with my wife.” “Nobody calls me, and I don’t want to talk to anyone anyway.” “I could not be a good person so far. I don’t think I’ll be of any use in the future, either.” “Everything around me seems to be bleak and dark.” “Everything I used to like, that I thought made me happy, is meaningless now.” “My feelings seem to be taken away.” “I want to move, but I feel like I don’t have the energy.” “I’m distracted, it’s like a battlefield in my head.” “Sometimes I ask myself why I live.”

What is depression?

Depression is a common psychiatric disorder that is often characterized by a sense of incapacity that affects not only the individual but their whole family and even has effects on their broader societies. Throughout daily life, we often hear the phrase “I am depressed.” However, depression is not an illness that can be “entered” and “exited” so easily; it is a disorder that needs to be diagnosed by experts. It is normal for us to undergo mood swings throughout our days, and these differing experiences of sadness, sorrow, or lack of excitement do not necessarily qualify as depression. It is important for us to do our best to understand ourselves and our emotions, specifically what causes us to feel unwell and to learn from these mood swings.

Nowadays, there is a perception as if life should always be experienced in joy and that emotions such as sadness and sorrow are completely pointless and should be avoided at all costs. However, people mature when they face difficulties and can learn to confront their problems, instead of running away from them, as they endure hardship. In fact, most of the time, we discover different aspects and abilities about ourselves during such periods.

Am I depressed?

It is most important to first and foremost state that any person seeking to learn if they do or do not have depression should consult a physician for a professional diagnosis. In order to be diagnosed with depression, a depressive mood and the inability to enjoy life must have been present for more than 15 days. Furthermore, at least four of the below symptoms should coexist:

• feeling of worthlessness and guilt
• lack of energy, tiredness
• sleep disturbance (decrease or increase)
• appetite disturbance (decrease or increase)
• concentration disorder
• loss of interest
• recurrent thoughts of death

Just as depression worsens the course of chronic diseases, chronic diseases also make it difficult to treat depression. It should be investigated whether an organic disease accompanies the symptoms at the diagnosis stage. For this purpose, thyroid function tests should be performed and anemia, vitamin B12 and D levels should be checked. Any diseases or problems related to the body should be treated simultaneously.

Causes of depression

Modern science has not yet been able to fully explain the mechanism by which depression occurs. The general view is that it is related to the molecules that are involved with communication between cells in the brain. Biologically, differences in the levels of molecules such as serotonin and noradrenaline change our perceptions. In addition, the finding that depression in first-degree relatives triples the risk of disease suggests that depression may have a genetic basis. Not being able to think properly, and exposure to intense stress, can also lead to depression.

Risk groups

Factors that facilitate the development of depression vary. It has been found that twice as many women compared to men are afflicted. Among risk groups are being in the middle age group; not being married (depression rates are higher among widows, the divorced, and singles); having a low income; alcohol or substance addiction; and chronic illness.

Treatment

Medication and psychotherapy options are available as the current treatment options for depression. For an effective recovery, both approaches should be used together. Depression is a disease and medication must be used in its treatment; therefore, the initial depression diagnosis means that the decision has already been made to start taking medication. Liver and kidney function tests should be done before a patient begins using medication.

Patients should be advised that drug treatment will take a long time and it may take up to six weeks before the actual effect is noticed. This time is necessary for the adaptation of our brain cells. As the drug starts to produce visible benefit, the person may opt to stop taking the drug thinking that they are out of depression and that the drug is no longer needed. Discontinuing drug treatment leads to the continuation of the disease and therefore causes further despair.

Since depression does not start in only a few days, treatment should not take place in a short time either. Depression is shaped in relation to the perceptions, interpretations, and relationships of the person’s environment, and its treatment is a comprehensive process. Since the decision to start treatment is made by the doctor and the patient together, the decision to discontinue the drug should be taken together as well. Psychotherapy is an important stage that contributes to the healing process. In addition to this therapy, the patient is taught the methods of how to cope with the illness to prevent recurrence of it.

It is necessary to think of stress as a microbe entering our body. Even though we try not to get sick, our immune systems and bodies are renewed and become more resistant to different seasonal diseases two or three times a year. We do not say we should not get sick, as we consider disease conditions such as a sore throat, ear infection, and flu to be normal. However, we generally do not want to be exposed to stress and we do not tolerate the changes that stress will make in our body and the effects that it will have on our outlook on life.

Things to keep in mind

• Depression should be diagnosed by a doctor.
• You should be prepared for a long treatment process.
• Serious life decisions should be postponed until after treatment ends (such as undergoing a divorce, job change, moving).
• Comparing your quality of life to the life of others should be avoided.
• Physical exercise, like walking, is necessary, a balanced diet should be kept, attention should be paid to maintain adequate and quality sleep, and a regulated lifestyle should be adopted.
• Listening to soothing music and reading books 15-20 minutes before bedtime can be helpful.
• As we go to bed, statements of determination, like “I will take this small step tomorrow” should be repeated. Such conditioning can help strengthen our willpower and win the war against depression.

Depression should not be feared. Every small step taken in the treatment process will positively grow gradually. Not rushing through treatment is very important, as the process is more of a marathon than it is a sprint.

As with any illness, it is important to follow the advice of a specialist. These doctors will give their patients legitimate advice that help to turn the patient away from exaggeration and understatements and more towards balance, appreciation, and gratitude. Evaluating a problem as a means of test from God and knowing that the world is not a place of taste and remuneration, will change our view towards life. This perspective will also make a difference in our reactions towards all of our problems.

Spirituality has the potential to aid people in their fight against depression and grappling with life can bring great psychological duress upon a person. Human beings are able to “read” and understand, to a degree, our changing universe and the events that come into existence. Contemplating and striving to understand the comprehensive rules that exist in the universe can allow us to develop an appreciation for existence through a believer’s lens. This appreciation can lead us to a greater sense of harmony and purpose in life, and the simple fact of having a solid foundation that we feel comfortable with can bring great tranquility to people whose minds are more concerned with the questions regarding life, creation, and the universe. We may instead feel lost, purposeless, demotivated, and more concerned with trivial worldly matters without this knowledge.

Biggest extinction in Earth’s history caused by global warming—and how it could happen again

Penn JL et al. Temperature-dependent hypoxia explains biogeography and severity of end-Permian marine mass extinction. Science, December 2018.

Some 252 million years ago, long before dinosaurs, the vast majority of species on Earth were wiped out in the “Great Dying,” the worst mass extinction in our planet’s history. Up to 96% of all marine species and 70% of land animals were killed off during this event. Scientists have been trying to find the cause for this catastrophic event, which marked the end of the Permian period. One study suggested that a type of microbe spouted large amounts of methane into the atmosphere. Other studies suggested the event was triggered by a series of volcanic eruptions that released deadly amount of carbon dioxide into the air and led to cataclysmic ocean acidification. A new research study now claims that the Great Dying was primarily as a result of rapidly increasing temperatures. The researchers examined the marine fossil records and simulated the climate conditions to observe the effects of rising temperatures 252 million years ago. Researchers first ran a climate model with Earth’s configuration during the Permian period, when the tropical ocean temperatures at the surface had reached some 10 degrees Celsius (50 degrees Fahrenheit) higher. The model then reproduced dramatic changes in the oceans; oceans lost about 80 percent of their oxygen and about half the oceans’ seafloor became completely oxygen-free. To investigate the effects of these paleoclimate changes on marine species, the researchers then analyzed the varying oxygen and temperature sensitivities of 61 modern marine species including crustaceans, fish, shellfish, corals and sharks. Their calculations predicted that many marine organisms went extinct under these conditions, especially the organisms that lived far from the tropics were most sensitive to oxygen levels and they were nearly completely wiped out. To test this prediction, researchers analyzed late-Permian fossil distributions from the Paleoceanography Database and confirmed that species far from the equator suffered most during the event. The agreement between the simulations and fossils strongly suggests that climate warming and oxygen loss was a primary cause of the extinction. By 2100, warming in the upper ocean is projected to approach 20 percent of warming in the late Permian, and by the year 2300 it will reach between 35 and 50 percent. This study highlights the potential for a mass extinction arising from a similar mechanism under anthropogenic climate change. It is also a clear warning that Earth is on the path to another devastating mass extinction. According to experts, Earth could already be undergoing a sixth mass extinction that would kill off most animal and plant species. The International Union for the Conservation of Nature predicts that 99.9% of critically endangered species and 67% of endangered species will be lost within the next 100 years.

New target for therapeutic brain stimulation to treat depression found

Rao VR et al. Direct Electrical Stimulation of Lateral Orbitofrontal Cortex Acutely Improves Mood in Individuals with Symptoms of Depression. Current Biology, November 2018.

Researchers have finally found an effective target in the brain for electrical stimulation to improve mood in people suffering from depression. Stimulation of a brain region called the lateral orbitofrontal cortex (OFC) reliably produced acute improvement in mood in patients who suffered from depression. In a recent study, researchers studied 25 patients with epilepsy who had electrodes placed in the brain for medical reasons to locate the origin of their seizures. Many of those patients also suffered from depression, which is often comorbid with epilepsy. With the patients’ consent, researchers took advantage of those electrodes to deliver small electrical pulses to areas of the brain thought to be involved in regulating mood. The researchers focused their attention and the electrical stimulation on the OFC, which is a key hub for mood-related circuitry. Moreover, they specifically induced a pattern of activity in brain regions connected to OFC that was similar to patterns seen when patients naturally experienced positive mood states. The researchers applied these stimulation regimes while collecting verbal mood reports and questionnaire scores. Analyses of these reports revealed that unilateral stimulation of the lateral OFC produced acute, dose-dependent mood-state improvement in subjects with moderate-to-severe baseline depression. There is still substantial work remains to be completed before the deep brain stimulation (DBS) treatments could enter routine clinical practice. One major challenge in this study is to see whether stimulation of OFC produces durable improvement in mood over longer periods of time. Biomedical engineers hope to develop a medical device for patients with treatment-resistant mood disorders that can monitor brain activity in OFC and stimulate only when needed to keep that activity within a healthy range. Ultimately, it would be ideal if activity in mood-related brain circuits could be normalized indefinitely without patients needing to do anything.

How screen time can disrupt sleep

Mure LS et al. Sustained Melanopsin Photoresponse Is Supported by Specific Roles of β-Arrestin 1 and 2 in Deactivation and Regeneration of Photopigment. Cell Reports, 2018

For most of us, the time spent staring at screens on computers, phones and tablets adds up to many hours in a day and can often disrupt sleep. In a recent work, researchers now have pinpointed how certain cells in the eye process ambient light and reset our internal clocks, the daily cycles of physiological processes known as the circadian rhythm. When these cells are exposed to artificial light late into the night, our internal clocks can get confused, resulting in a host of health issues. A protein called melanopsin in these light-sensitive cells helps them process ambient light. Prolonged exposure to light causes melanopsin to regenerate and continuous regeneration of melanopsin triggers signals to the brain that inform it about ambient light conditions. The brain then uses this information to regulate sleep, alertness, and consciousness. In this study, the researchers turned on the production of melanopsin in retinal cells in mice and found that some of these cells are able to sustain light responses, but others lose sensitivity. Further investigations found that proteins called beta arrestin-1 and beta arrestin-2 help keep the melanopsin sensitive when exposed to light. One arrestin does its conventional job of arresting the response, and the other helps the melanopsin protein reload its retinal light-sensing co-factor. When these two steps are done in quick succession, the cell appears to respond continuously to light. This research uncovers the mechanisms behind how cells being exposed to artificial light confuses the internal body clock, and the ability to regulate sleep. It is hoped that this discovery could lead to new targets that could counter the impact of artificial light, for example by finding ways to influence melanopsin to reset the internal clock. This could lead to new treatments for insomnia, jet lag, and migraines.

He is the one who knows the sorrows of broken hearts, who alleviates incurable troubles, and who eliminates the loneliness and depression in our souls with breezes from His realm. Those who turn to Him turn to an opened door; those who supplicate to Him have realized the very purpose of existence.

Those who recognize Him through His works, those who truly know and feel Him through their consciences, need to learn nothing else. In the minds of those who attain knowledge of Him, pieces of that knowledge become crystal domes over diamond pillars. For the souls who do not recognize Him, knowledge is apprehension and all existence we explore with science becomes nothing more than a collection of lifeless bodies.

In the radiant climate of belief, all creation becomes clear as water, from beginning to end; thoughts and events become distilled and everything flows to Him. Those who turn and implore Him with such pure feelings and thoughts are the most fortunate among us.

Given this, wherever we are in the world, whatever the time of day, whenever we feel lonely, let us turn to Him with our whole being, open the doors of our heart to Him, and one by one, confide in Him our sufferings, pains, desires, and wishes, great or small. Then we will feel our pain alleviated, our suffering replaced with contentment, and our souls will be enveloped by the breezes of Divine favors.

Those who confine themselves within the material world will likely never feel Him. Still, with thousands of signs for those who see, He will make His presence felt in our consciences, that He is not distant, and make our hearts smile.

Nights are openings to such inspirations. The souls awakened to the truth, who turn their hearts into bright mirrors shining with Divine epiphanies, wait for blessings to pour on their prayer rugs. We, too, can watch for the surprise blessings of the night, even when we are alone. Such moments can be our time of reunion, when we can stand in His presence and open up the secrets of our heart to Him. Only share your troubles with Him, moan in His presence, and bring your head to prostration, which is the first threshold on the path leading to Him, and wait! Then you will feel doors opening to your heart, one after the other. You will melt under the lights of His being; your respective presence will vanish like a drop falling into the ocean, and in a zone beyond considerations, you will become one being united with the gigantic waves.

The deeper you allow yourself to fall into Him, the deeper the realms that will open to you, and the higher the peaks you will scale. If you set sail to these inner depths with full conviction, you’ll think you’ve skirted the eternity of Paradise, the pristine atmosphere of the realms beyond. With every new step, you will see a different favor of being closer to God.

The souls who see nothing but the material reality and fail to attain the many levels of greatness, magnificence, and inner depth will continue to stagger in darkness, never managing to break free of deprivations and depression.

If only they, too, could feel the depths within their soul, as deep as clear skies and as vast as the universe. If only they, too, could discover the light inside them, and use that light to illuminate the secrets of our Creator’s realms.

Some fail to find these radiant ways which exist as a seed inside them and lead a life unaware of this lofty truth. They fail to blossom and are trapped in physical longevities instead of discovering roads to eternity. I do not know if we should feel pity for them or pray that their eyes open to truth.

All health issues are best understood and treated with a combination of biological, psychological, and social factors rather than with purely biological means. This context entails thoughts, emotions, behaviors, social factors, and environment, all of which play significant roles in human functioning and overall health. Therefore, it is important to gather input from all aspects of an individuals’ life to get better insight into depression.

Many people use the word “depression” to explain the feeling of sorrow, but depression is much more than just sadness. Sadness is a normal reaction to life’s struggles, setbacks, and disappointments. However, depressed people don’t feel sad—they may feel lifeless, empty, apathetic, and hopeless. Depression starts with just a feeling and then manifests in physical behaviors. The feeling of helplessness, hopelessness, and worthlessness are intense and unrelenting. An unwanted complication of depression is suicide, which in fact has a higher rate than homicides in the US (1).

Hopelessness is the main indicator leading to suicide, a trapped pattern of thinking where individuals believe things will never get better. The deep despair and hopelessness that accompanies depression can make suicide seem like the only way to escape from the overwhelming circumstances. Therefore, suicidal thoughts must be considered as a cry for help and dealt with accordingly.

Psychosocial context appears to be the commonly associated culprit that may predispose people to depression instead of genetic predisposition and other secondary etiologic factors. Depression in the psychosocial context is related to a person’s perception of daily events. A specific event in a person’s life can trigger the beginning of a vicious cycle. Examples could include: changes in occupation, loss of a loved one, etc.

Modesty

In addition to hopelessness, avarice can lead to depression because it contributes to dissatisfaction, disappointment, and loss of sincerity. Sometimes, the lack of material goods can make a person happier than having them. Jealously chasing material things that others have can lead a person into depression. For example, the ancient philosopher Plato was wise but not wealthy; despite his lack of money he was content with his life. One day, as he was passing by a spring, he noticed a boy drinking water with his hands. The average person, having witnessed this, would give the child a cup, but Plato asked himself if the cup is even needed. If you focus on what you do not have, you will always be disappointed. Actually focusing on what you need in the present time can decrease the damage one incurs from his or her problems. The child was thirsty and he only needed water, so the cup was unnecessary.

If a person is only concerned with his or her own situation and not noticing the condition of those around them, it can turn trivial problems into mountains. By comparing one’s own problems with greater problems of others, the person can get a more accurate perspective. Though a person’s burden may appear unbearable, God has created each person with the ability to handle these burdens. It is recommended to keep hope by exercising patience and concerning yourself with the present condition rather than bringing problems up from the past or worrying about the future. The patience given to human beings is sufficient to all types of difficulties, unless used inappropriately to obsess about what already happened in the past or to worry about distant future.

Never lose hope

As shown in Table Figure 1, The American Psychiatric Association (APA) has established the universal criteria for health professionals to diagnose depression. According to The Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV) criteria, physicians diagnose an individual as having depression, which is further classified as minor or major in terms of the severity of the symptoms (2).

Hopelessness deserves special concern because it often triggers the other symptoms which may eventually lead to inertia.

Belief and prayer have found to be extremely helpful in combatting hopelessness by keeping hopes high. This can help to prevent serious depression or even suicide, for even in the most difficult times, belief can allow a person to stand firm with the conviction that even a single leaf would not drop without God’s knowledge. The Qur’an states: “Say (God gives you hope): ‘O My servants who have been wasteful (of their God-given opportunities and faculties) against (the good of) their own souls! Do not despair of God’s Mercy. Surely God forgives all sins. He is indeed the All-Forgiving, the All-Compassionate’” (The Qur’an 39.53).

The Bible echoes a similar tone when it says, “For as high as the heavens are above the earth, so great is his steadfast love toward those who fear him; as far as the east is from the west, so far does he remove our transgressions from us (Psalm 103, 8-12).

What does the literature say about belief?

A survey revealed the fact that 82% of Americans believe that prayer can cure serious illness, 73% believe that praying for others can cure illness, and 64% want their physicians to pray with them. Health professionals – especially doctors and nurses – should be aware of the spiritual needs of their patients, should be familiar with literature on the effectiveness of prayer, and should integrate it into their comprehensive care plans (3).

From the biological perspective, as shown in Figure 2, symptoms and signs of depression shown in Figure 1 occur as a result of the change in the level of neurotransmitters – namely serotonin, norepinephrine, and dopamine. Today, pharmacological interventions to heal depression are mainly provided by drugs. These regulate the levels of the neurotransmitters. There aren’t many scientific studies focusing on depressing and religion, however McCullough’s review of literature clearly states that “People with high levels of general religious involvement, organizational religious involvement, religious salience, and intrinsic religious motivation are at reduced risk for depressive symptoms and depressive disorders” (4).

In conclusion, depression may arise from the lack of staying active. In order to keep away from the negative thoughts which serve as a starting point for depression’s vicious circle, praying and seeking help from the All-Knowing, All-Wise serves as a shelter from the negative feelings of temporary worldly troubles. Praying may provide a protection against negative thoughts that may arise from an external or internal source, eventually leading to a distortion of healthy thinking.

Subjective healing and improvement in health after praying, psychological therapy, and family and social support may stimulate some neurotransmitters, though this needs to be further clarified by comprehensive studies (5). However, even simple words may have an impact on the mood of any individual. Hearing a compliment may cause a smile, or receiving a phone call giving a bad news might cause sadness. How could sincerely pouring one’s heart out to the All-Knowing not reverberate from His eternal source into the body, even if the circumstances appear overwhelming?

Mucteba Muezzinoglu is a freelance currently living in Illinois, US.

Nate Emru is a Mental Health Counselor in Indianapolis, Indiana, US.

References

1. Further information is available at http://www.sprc.org/basics/about-suicide. Reached in April 25.
2. The Diagnostic and Statistical Manual of Mental Disorders (DSM). American Psychiatric Association provides a common language and standard criteria for the classification of mental disorders.
3. Ameling A. 2000. “Prayer: an ancient healing practice becomes new again.” Holist Nurs Pract. Apr;14(3):40-8.
4. McCullough ME, Larson DB. 1999. “Religion and depression: a review of the literature.” Twin Res. Jun;2(2):126-36.
5. National Institute of Mental Health. What medications are used to treat depression? Reached from the website. http://www.nimh.nih.gov/health/publications/mental-health-medications/complete-index.shtml#pub5

Nowadays, forgetfulness has become a very common problem among both young and older people (Bambroo, 2010). There are various elements that lead to forgetfulness and poor memory; carelessness, not knowing the principles of memorization, and not using information are some of them (Tarhan, 2007). Therefore, the factors that cause weakness of memory are extremely critical. This article elucidates the causes of poor memory from emotional aspects such as depression, stress, and a confused mind as well as the behavioral aspects of alcohol and drug addiction, and alternative religious inspirations to help tackle the causes of bad memory.

Firstly, depression and a stressful lifestyle are deeply critical causes of bad memory and can lead to forgetfulness (Bambroo, 2010). Today depression has become a very common disease that can occur at any age. There are many reasons causing depression. Events like loss of a beloved person are usually accompanied by depression and result in problems with memory (MYLN, 2008). In addition, all negative emotions such as anxiety and anger can hamper the ability of our brains to remember. In particular, depression is the primary negative emotion to influence our memory because it interferes with our ability to concentrate (Edmonds, 2009). Some people might keep forgetting things, even though they need to concentrate to be able to work or study. Turning negative emotions that come from depression into a positive philosophy of life will aid the memorization ability.

Secondly, a confused mind is one of the most significant reasons for poor memory. Every day we get new information from everywhere, and we are exposed to more knowledge than we need. Even though some of them can be beneficial, most are useless to the effect that they dominate over the useful ones. Some scholars support the idea that mental pollution is one of the main reasons for poor memory nowadays (Gülen, 2007).

Next, some experts highlight that neglecting the emotional dimension is another reason for poor memory. A theater actor perfectly memorizes his role because he learns to pretend the emotions. Interest enhances emotional power, therefore it is said that interest is the teacher of learning. The left part of the brain does logical functions; however, the right part of the brain carries out emotional and artistic functions (Tarhan, 2007). In addition, Prof. Robert Ornstein, from the University of California, explains that people who use both parts of their brain in a balanced way, have five times more brain capacity than others (Tarhan, 2007). Therefore, using only the left hemisphere of the brain and neglecting emotions can result in having a weak memory, as well as forgetting information in a short time. For example, if we memorize five words without using emotional dimension, we can save them for a little time; however, if we create connections and acronyms among them or produce a story, these kinds of emotional aspects help us to save them for a long time.

Furthermore, alcohol and drug addiction can weaken the human memory. It has long been known that cannabis (an illegal drug, “marijuana,” made from the dried leaves and flowers of the hemp plant) causes memory loss by acting on the hippocampus, which is the area in the brain that rules most of our cognitive functions (Hood, 2009). Moreover, according to scientific research, heavy alcohol use clearly damages retrospective memory, namely, the learning, preservation, and recovery of previously presented materials (Buddy T., 2006). Furthermore, excessive alcohol consumption can result in blackouts-periods of temporary memory loss or amnesia. When a person consumes alcohol, the body immediately starts to break it down. The brain receives less oxygen when alcohol is present, and alcohol has a damaging effect on the central nervous system (Wellness Trader, 2010).

Religious inspirations, as well as religious life can help us cope with poor memory. According to Shatibi, an Andalusian Muslim scholar, there are five main purposes of the religions. They are protection of religion, protection of life, protection of progeny, protection of the mind, and protection of wealth. All religions and nations may observe these higher objectives (Shatibi, 1388). In this respect, all actions that might harm the mind are prohibited by Islam, and all activities that lead to the development of mind are recommended. Alcohol use and drug abuse are prohibited because they damage the mind. Moreover, the depression and stresses that often accompany modern day life can be overcome by remembering to place trust in God in every situation regardless if it is good or bad. As Bediuzzaman indicates “Those who attain true belief can challenge the universe, and in proportion to their belief’s strength, be relieved of the pressures of events. Relying on God, they travel safely through the mountainous waves of events in the ship of life. Having entrusted their burdens to the Absolutely Powerful One’s Hand of Power, they voyage through the world comfortably until their last day” (Nursi, 2010).

Hakan Coruh is a PhD student in Qur’anic exegesis at ACU National, Melbourne, Australia.

References

• Bambroo, C.J. (2010, May 10). Forgetfulness, a growing problem. Retrieved June 01, 2010, from http://www.hindustantimes.com.
• Buddy, T. (2006, July 09). Alcohol Damages Day-To-Day Memory Function. Retrieved June 01, 2010, from http://alcoholism.about.com.
• Edmonds, M. Top 10 Ways to Improve Your Memory. Retrieved June, 2009, from http://health.howstuffworks.com.
• Gülen, M. F. (2007, May 28). Mefluç Dimaglar ve Unutkanligin Reçetesi. Retrieved June 01, 2010, from http://www.herkul.org
• Hood, M. (2009, August 2). Pot shot: Scientists find cannabis trigger for forgetfulness. Retrieved June 01, 2010, from http://www.physorg.com.
• Mayda, A. (2010, January – February). Memory and Forgetfulness. The Fountain Magazine, Issue: 73, Retrieved June 01, 2010, from http://www.fountainmagazine.com.
• MYLN. (2008, December 2). 6 Ways To improve memory. Retrieved June 01, 2010, from http://www.manageyourlifenow.com.
• Nursi, Bediuzzaman Said. 2010. The Words, NJ: The Light, Inc., p. 330.
• Shatibi, E. Al Muvafakat. Al Maktaba Al Ticariyye Al Kubra, v: 2, p: 10.
• Tarhan, N. (2007, July 27). Beyin Sagligi ve Unutkanlik. Retrieved June 01, 2010, from http://www.aktuelpsikoloji.com.
• Wellness Trader Tm. (2010). Alcohol and Memory Loss. Retrieved June 01, 2010, from http://www.memory-loss.com.

Matter&Beyond: What was your motivation for writing the book, The Heart-Mind Connection?

Well, that book was a collaboration with Dr. Ting who is a Cardiovascular Surgeon and it was actually his idea. He’s a very enlightened surgeon in that he, over the years of training in a practice as a cardiac surgeon, came to realize that the experience of undergoing cardiac surgery certainly taxed the mind and that the interaction of mind and heart was extremely important for outcomes. If you’re a cardiac surgeon and your goal is to improve your patients’ lives it became very clear to Dr. Ting that in order for that to happen cardiac surgeons and cardiologists had to be mindful of the fact that patients needed to be emotionally and cognitively intact, and so he asked me to collaborate on this book, and the book focused on the interaction between mood states and cardiac states.

M&B: What is the nature of this interaction? Does the heart affect the mind or does the mind affect the heart?

It’s bidirectional. There is an interaction or there is a relationship between mood disorders such as depression, anxiety, anger, and hostility and the actual human heart. The connection between those mood disorders and cardiac function is extremely important. But then also if you go into the experience of having heart disease and you were fortunate enough not to have one of those mood disorders, the experience of having cardiac disease will put you at risk for developing mood disorders. So it’s bidirectional. You can start out with heart disease and wind up having your health complicated by mood problems, or you can start out with mood problems and have your health complicated by heart disease. There’s an unholy alliance between depression and anxiety on the one hand and heart disease on the other.

M&B: What happens, let’s say, if you are someone who has a history of a major depressive disorder? What happens to his or her heart?

Major depressive disorder is a condition characterized by certain clear-cut symptoms, and those symptoms include having a depressed mood everyday most of the day for two weeks or more that includes losing pleasure in life, something we call anhedonia, not being able to take pleasure in normal activities that would normally make you happy. Along with that is loss of interest in things, guilt, or feelings of hopelessness, helplessness and worthlessness, loss of energy, loss of concentration, loss of appetite, sometimes even leading to weight loss, not being able to move the way you’re used to. So it’s sometimes you just curl up in bed and this is something we call psychomotor retardation or withdrawal. On the other hand sometimes depression makes you agitated so you can’t sit still and you’re running around sort of ringing your hands and so on. And then the final symptom of major depression is suicidality or morbid thinking. Always focused on death or wanting to die. So that’s the common sort of a cluster of symptoms we see in major depression. Now, say you have no history of heart disease but you suffer from major depressive disorder. You increase your risk of developing heart disease by having this condition of depression. So your risk of having a heart attack for example goes up like 1-1/2 to 2 times what it would be in someone without depression.

M&B: Is it similar with anger and hostility?

Some people believe that if you’re an angry person or a hostile person, that also increases your risk of developing depression. Say you have depression and you unfortunately have a heart attack. If you remain depressed then your risk of having another cardiac event, another minor cardiac infarction or a cardiac arrhythmia would go up three and a half times what it would be if you weren’t depressed. So that means that this connection between the brain and the heart, between depression and cardiac disease are tremendously important in terms of public health. Because those two diseases are causing most of the disability that exists, by the year 2020, the World Health Organization predicts that heart disease will be number one and depression will be number two in the entire world. That includes the developed world, the industrialized countries as well as the developing low income countries around the world. So in terms of the book that we did we thought it was important because these two illnesses, first of all feed off each other and cause a lot of heartache in the population but they also are the most important diseases in public health.

M&B: The heartbeat change is associated with love or certain joy. What is the physiology behind that?

Let me preface it by saying that this is the age old philosophical question which Plato and Aristotle sort of debated. Love is an idea as Plato thought. So, is there sort of an idea of beauty and of love that exists outside of the materialistic world? Are we somehow plugging into that ideal world of love as material organisms? Or does it come as a result, as an epiphenomenon of the material world we’re living? Does it emerge from the biological material world that we’re living? That in a way becomes a philosophical question. As scientists when we see human behavior, there’s something that we do, and it’s called reverse engineering. Let’s look at the behavior or the experience of human love. Where does that come from? Let’s work backwards from human love to try to understand in a biological way where it came from. We are the ultimate mammalian life. We might start a little controversy about that and especially with the all wars that we fight, but be that as it may, we are these high level, high functioning mammals. Our infants are born [in need of] altruism, which means that they are absolutely helpless when they are born. So parenting for the human being is extraordinarily important for the continuity of our species, and so our infants are in total need of care.

M&B: Isn’t this the same for all the animals?

It’s different in reptiles. If you go to Borneo and you study the life of the Komodo dragon, you’ll find out that komodo pups know immediately what they have to do when they plop out of komodo mommy. They have to roll around in their own feces in order to throw mommy off the scent because mommy will look at them as food. So that’s their strategy for avoiding being eaten by mommy. They also know how to climb up trees to get away from mommy. So here the survival strategy of reptiles is not one of attachment; it’s one of separation. All psychiatry is tied up in that simple fact. There would be no psychiatry if we were reptiles. But because we’re mammals, there’s psychiatry because all of the disorders we have are really disorders of a dysfunction in parental and social attachment. Only mammals for example have a part of the brain called the paralimbic cortex. So reptiles have primitive limbic areas, they have hippocampus, they have amygdala, so they show fear, and they act when they’re threatened, etc. They’re outfitted with those structures which allow them to do those simple attachments-attachments to food and to sexual objects etc., but don’t allow them to do social attachments very well, and there’s some reptiles that are better at it than others. Crocodiles, for example. They do a version of taking care of their pups. Birds also take care of their nestlings very well, and crocodiles actually have brains that are more kind of on the bird-like end of the spectrum, allowing them to do a better job as reptiles taking care of their young and having something of a social life. Nothing to the extent that mammals do and you can look at a mammal brain, and you can see where this is taking place. So the anterior cingulate is an area of extreme importance for mammalian behavior.

M&B: This unique mammal feature, the limbic system and the paralimbic system; would you elaborate a little bit more on them?

I had the privilege of meeting back in 1990 Paul McClain, who is a famous neuroscientist who coined the term limbic system. He studied emotional parts of the brain in reptiles and in monkeys and in human beings. He talked about what he called the mammalian behavioral triad. There are three things that mammals do that reptiles don’t do very well. One is that all mammalian infants cry for their mothers in the same way, so every lamb baas for its mother the same way. Every human infant cries for its mother in the same way, that’s called a separation cry, and you can study it. So when you look at rats they have an ultrasonic isolation cry; you can study it, and you can deprive them of relationships and you’ll see the cry. That’s typically mammalian. Another feature is play, so mammals play, and that serves a social binding function. We play sports together; it serves a social binding function. Then the third thing is maternal nurturance which is extremely important, and mammals do that parental nurturance piece pretty well.

M&B: Are there any experiments that may illustrate the role of love?

There are a couple of experiments that Paul did and they are very illustrative. They get us back to a focus on love. So one experiment was to take hamsters and you can ablate, sort of take out the anterior cingulate. When you do, the hamster pup no longer cries for its mother when it’s separated and the hamster mother no longer responds when the hamster pup cries for her. You can also put morphine in that area, and get pretty much the same results. So you could put morphine in the hamster pup’s brain in the anterior cingulated, and the hamster pup will no longer cry for their mother, it distorts that bonding. And you can do that with squirrel monkeys too and you’ll get similar results.

M&B: Do the results apply to human beings as well? Could the use of morphine stop a healthy heart or brain from giving love or responding to love?

One of the real problems that we face in psychiatry is when we run across an addicted mother. What happens to the mother child relationship when the mother is addicted to heroin or to cocaine or to other drugs of abuse? The child gets neglected, the mother no longer responds to the needs of the child. So we see there’s even a reflection of those basic experiments in the human model when we’re talking about maternal-child relationships. So again that’s kind of circumstantial evidence where there’s reverse engineering, and mothers also have this phenomenal hormone, neuropeptide hormone, this again is exclusively mammalian, called oxytocin. So it’s used in pregnant women to get them ready to give birth, and so once a pregnant woman gives birth it’s responsible for milk production and so on. This is another example of this – if we think about maternal love, one of the requirements for maternal love is that there needs to be oxytocin involved. Oxytocin needs to allow that brain to have the experience of being connected and bonded to offspring.

M&B: The relation between the brain and the other organs such as the heart, is it really a top down relation where the brain commands, or is it a bottom-up relation where bodily sensors form the human brain?

What you’re referring to when you bring up this fact that the body sends markers up to the brain, and the brain takes note of that and becomes behaviorally engaged, that is absolutely true, and it’s something that Tony Damasio calls a somatic marker hypothesis of how the brain works. This is also something that William James postulated in the late 1800s-that emotion is a reflection of the body’s activity. Your heart racing or your stomach turning, emotion is secondary, it’s the brain trying to make sense of what the body is going through. What came first, the chicken or the egg, that kind of a problem. The fact is, the organism works as a unity and you need all of its component parts for it to work, and you really can’t tease a part, what came first and what came second.

M&B: From our physiology, it is evident that we are born to love.

It is very spiritual about this kind of understanding of love and connecting it back to the brain. How the heart becomes a reflection of what the brain is about, and also this need we have as human beings for connection. Spirituality really is this need we seem to have as human beings to be connected to something greater than ourselves. So we have this part of our brain, the prefrontal cortex, which allows us to think into the future and when we think into the future, we gain security when we see a future of connectivity, of attachment. That becomes a workable definition of spirituality. So many of us feel connected to a higher power, to God or to nature, but that is also a common reflection of what people refer to as love, and again you can choose to understand its biological origins. The body will be connected up with that whole experience, so your heart will be connected up. If you’re feeling connected to God, or to the scene of an ocean, and you’re feeling connected to the universe, when you’re looking up at the stars, there will be a bodily sensation connected up with that experience, and that will become for you part of what you understand to be spirituality.

Humanity has come up with many beautiful things, and has made great inventions up to now. In a way, it is thanks to these efforts that the people of our time are enjoying a life of comfort, never equaled in any period of history; at least, this is potentially so. Even though it would not be correct to speculate today on the days to come, those who predict the future of the world say that it will, in a way, become so attractive for the people of physicality and carnal pleasures that it will make them forget Paradise. With a feeling and passion that gives priority to immediate pleasures and delights, they will say like Omar Khayyam, “The past and future are all but tales; enjoy yourself, do not spoil your life.” Thus, they will see life as only eating, drinking, and lying down, constantly making their choices in favor of worldly ease and comfort.

Actually, we can see this even now in many developed countries, and a great number of people around the world are enviously trying to imitate them. Almost everybody speaks about “material welfare and comfort,” without seeing other values than these, or rather without wanting to see them. However, in spite of the dizzying developments brought by science, the new opportunities offered by technology, and so many means promising us welfare and happiness, the people of our time do not seem so happy. Let alone seeming happy, they are seized by unease and depression more than ever. Though it could not be expected to be any other way, mere worldly opportunities, which are not supported by their relation to faith or knowledge of God, not deepened and given meaning, would obviously not mean much. In this respect, what we need in this modern age is nothing but to choose the best stature as suggested by the truth of having been created as “the perfect pattern of creation” (Tin 95:5), and to read the essence of being human accordingly. We can call this human beings’ realization of their difference with respect to spirituality and heart, reviewing their relation with the Creator, and finding their own orbit as befits the purpose of their creation. It seems that until they learn to read their essence correctly, it will not be possible for human beings to put their affairs in order and attain the happiness they expect. And particularly so if they are trying to suppress their spiritual appetite through luxury, comfort, and seeking to satisfy their physical pleasures due to not being able to know their real problems.

Even though the gravity of problems varies according to the country and society, almost all of humanity today faces serious dead ends. Almost everywhere, in every society, the masses experiencing a void in the name of faith and knowledge of God are pushed-consciously or not-into a disordered life, their animal desires are constantly triggered, and they are intoxicated into oblivion. Obviously, there cannot be sound spirit, sound thoughts, and sound judgment in such carefree, lawless, and immoderate masses. Masses of this sort have no aim or activity other than satisfying their carnal senses and consoling themselves with alcohol and drugs. Such a society can be considered to be spiritually dead, or to have entered the grave before dying. For such miserable souls who have lost their feeling of being human to some extent, it is just ordinary to have perverted habits, nervous problems, stress, and depression. Unfortunately, along with the entire world today, Muslim countries are also afflicted with the same diseases, and they are going through their most unfortunate days in desperation. In this world, individuals are diseased and shaken, the home is miserable and messed up, the masses are delirious and aggressive, and the representatives of brute power are cruel and merciless; nobody knows where it will lead and what kind of an end awaits humanity…

Due to such intermingled uncertainties and misery, most are unaware of what they are doing, what purpose they are serving, and what kind of disintegration they are heading toward. Most are completely unaware of the background of these dreadful problems, the real reasons for the total degeneration of societies, and the spiritual deformation of masses. The cause or causes of disease are not known exactly, and therefore the remedies offered are mistaken to a great extent. The question of how many people have been able to diagnose the problem is always arguable. And God knows how many of them are even given the right to speak.

It is for these reasons that in spite of all means of welfare, humanity is unhappy, weary, worn, delirious, and bent under the burden of bad conscience. Individuals and the masses are in an intimidating void-the void of conflicting with our primordial nature-generated by not knowing one’s Master. This is the void of being ignorant of faith and wisdom and the void of having been dragged into the pitfalls of the carnal self. Therefore, people are in constant anxiety as if journeying through the corridors of Hell and are extremely uneasy. Neither leading their life in luxurious buildings, nor their fantastic clothing mean anything in the face of this void in them. Sometimes the delirium of intoxication is resorted to, and sometimes contentment is sought within material and carnal desires… but to no avail. None of these suffices to fill the void inside, and the generations of today, who are deprived of spiritual support, keep drifting from one delirious state to another.

Because of mad crowds detached from their past, with no connection with their future, and vulnerable to committing crime, almost everywhere human life and property are under threat, those who care about chastity are anxious, and those responsible for security are ashamed of being unable to cope with the different illegal organizations they face every day. Those who see these on television or in the newspapers wonder, “Is it the end of humanity?” and they shake with the fear of being dealt a divine blow. We cannot consider them wrong, since Sodom and Gomorrah were smashed to the ground in chastisement for such spiritual disintegration and debasement. The people of Noah was destroyed for a quarter of today’s present immorality. If the destroyed peoples of Ad, Thamud, and Ayka were to witness what is happening today, they would probably be deeply ashamed. As the poet Mehmed Akif expressed it:

Modesty has been raised, shamelessness all around,
What ugly faces that thin veil proves to have disguised!
No fidelity, no loyalty to promise, not a sign of the word “trust,”
Lies are favored, betrayal required, right is out of sight.
Let virtues be ignored, let consciences fall into silence.
If this moral corruption lasts, there will remain no independence.

In the face of such realities, the only way to be saved from the present dangers and from being caught in the torrents of misguidance is faith in God, the belief in resurrection and the afterlife, consciousness of the final judgment, and a new call to a total revival toward being ourselves. On the other hand, other cures which have been resorted to so far are obviously of no use at all.

The entire society is afflicted and faith is the treatment,

For souls starving for faith, other ways are torment.

We will wait and see; maybe one day God Almighty will open our eyes too.

We introduce a new dimension to psycho-pathology’s one-dimensional and nonreligious approach to spiritual disorders. Along with chemotherapy, religious strength or spirituality, a lack of which is the real cause of depression, will serve as a radical solution. In short, we propose the cooperation of psychiatry and religion.

The Two Fundamental Causes of Suicide

Preparatory Causes: The most important preparatory cause is religious debility, for religion (especially Islam) protects one from depression and thus from suicide.(1) One who cannot comprehend creation’s purpose and does not fear or love God is prone to depression and so experiences trouble and discomfort. But one whose heart is content with remembering God and who always feels His presence, as He is closer than his or her carotid artery, cannot become depressed.(2) True believers cannot follow a path that might imply rebellion against God; rather, they thank God and rely on Him during abundance and poverty.(3)

Humanity was created for a reason. This worldly life is ephemeral and a test to differentiate the good from the evil. Believers endure and continue to struggle. Besides, humanity is created with these feelings.(4) Those who read and understand the Qur’an properly will overcome their depression.(5)

The carnal self (nafs) urges evil, unless God has mercy on that person.(6) Thus a self that is not controlled by religious training stimulates evil (including suicide) and rebellion against God. Suicide is the result of the self working with Satan to urge the subconscious toward evil. Those who fear God and train their self can avoid this trap.(7) Perhaps Freud meant carnal (nafs-related) desires and feelings when he stated that the subconscious is full of evil desires (pan-sexuality). Perhaps what he called the œid was actually a perception of the carnal self. Perhaps his distance from any religion, especially Islam, caused him to characterize it incorrectly.(8)

Stimulating Causes: Weak faith, the primary cause, leads to depression and desperation. Islam prevents this and thus deters suicide.(9) Poverty and forlornness are the most important stimulating (secondary) causes. Even the Prophet sought refuge in God from poverty.(10) Materialists who cannot reach their financial or materialistic goals are likely to become depressed and commit suicide.

Although suicide has many causes, I consider economic causes paramount. Moreover fractiousness, the primary cause of divorce, is economic helplessness. But although suicide is inconsistent with human dignity and thus rebellion against God, its rates continue to increase.

People commit suicide for various reasons. Table 1 and Figure 1 show that suicide rates are highest in communist or former communist societies. This is due to the lack of spiritual and religious training and a long-standing policy of inculcating atheism and anti-religious sentiment.

For underdeveloped and developing countries, the reason is not primarily poverty. But for prosperous countries, which offer many opportunities to their people, the reason is the perceived spiritual and moral hollowness in the eyes of those searching for spiritual satisfaction. Thus they are more inclined to commit suicide. The highly prosperous countries of North America, Australia, Norway, and Sweden have the highest suicide rates; Muslim countries have the lowest rates, thanks to Islam. In Muslim countries, the primary reason is economic in nature.

Conclusion and Solution Suggestions

More psychiatric clinics or antidepressant drugs are not solutions. Drug therapy might provide a temporary symptomatic relief, but not a radical cure. Given this, religious and moral education should come first when developing a cure. This can be realized with religious education in the triad of family, house of worship, and school.

Believers will not know fear or sadness or be unfortunate.(11) Seekers of salvation elsewhere than in God’s mercy, however, eventually become depressed due to fear or melancholy, the primary causes of suicide and depression in general.

Depressed people should be urged to transcend aimless rehabilitation activities and engage in those with a spiritual or religious meaning. Prayer is the most important activity, for it protects people from evil.(12) As depression and suicide are spiritual sicknesses, prayer could cure them. People experiencing spiritual and psychological distress often display a lack of willpower and concentration. Prayer is the perfect medicine for such ailments.

In addition, the deep and humble reverence forming the goal of each prayer represents the summit of meditation and reflection. Qur’an 23:1 says that such prayers saves people. Those who pray also gain spiritually and economically: Thousands of stressed-out people flow into meditation centers, but prayer will discharge them with no cost and will gain God’s consent.

In conclusion, religion is as a shield that prevents evil, including suicide. Given this, psychiatry and religion must cooperate. In either diagnosis or therapy, success lies in such a cooperation.

Footnotes

1. Islam literally means peace, bliss, security, and soundness, and is the religion with which God is content. See Qur’an 3:19, 20, 83, 85, 102; 4:115; 5:3.
2. Qur’an 2:165, 5:100, 13:28, 39:22, 43:36, 50:16, 57:4, 103:1-4; Ramooz al-Ahadith, 2:369 and 1:46.
3. Qur’an 4:29-31; Tacreed Translation, 12:1940, 1989; 9:1413.
4. Qur’an 3:14; 4:77; 6:32; 9:38; 10:4; 16:41; 18:46; 21:36; 23:115; 29:2-4, 45; 42:36; 45:21; 67:2; 68:5-6; 75:36; 76:2; 90:4; 91:7-10.
5. Qur’an 2:155, 177; 3:134; 13:24; 16:126; 28:54, 42:43; 51:56; 68:35.
6. Qur’an 12:53
7. Qur’an 2:168, 4:29-30, 6:151, 12:53, 39:53, 43:36, 79:40, 91:7-10; Ramooz al-Ahadith 2:369.
8. The Merriam Webster Collegiate Dictionary defines œid as œone of the three divisions of the psyche in psychoanalytic theory that is completely unconscious and is the source of psychic energy derived from instinctual needs and drives
9. Qur’an 12:87, 39:53; Ramooz al-Ahadith, 1:46.
10. Fath al-Kabir, 1:1285-89.
11. Qur’an 2:38, 274; 6:48; 7:35; 20:123; 46:13.
12. Qur’an 29:45.

But this has started to change. Increasingly, professionals from respected institutions are conducting scientific studies of the effects of faith in healing. Recent conferences at Harvard, the Mayo Clinic, and the American Association for the Advancement of Science (AAAS) signal this change, as does major media coverage on PBS, NBC Nightly News, CNN, and CBS This Morning. Below we give examples of such scientific studies, the people behind them, and their findings.

Dr. Herbert Benson

Dr. Herbert Benson is an associate professor of medicine at Harvard Medical School and the founding president of the Mind/Body Medical Institute at Boston’s Deaconess Hospital. As the author of 150 scientific papers and six books, Benson has made important contributions to our understanding of the physiology involved in the healing effects of faith.(1)

As a young cardiologist working with people suffering from high blood pressure, Benson noticed that their blood pressure was the highest during office visits. He reached this conclusion after noticing that after treating his patients with anti-hypertensive medicines to lower their blood pressure, they would report such symptoms as fainting. This indicated that the adjusted blood pressure was generally too low. Since doses were set according to measurements made during the visit, the calibration was correct. He concluded that their blood pressure should have been lower before or after the visit.

To establish a model for stress-induced hypertension, he stopped his routine in cardiology and returned to physiology research at Harvard Medical School. Once when he was studying monkeys, about 15 young people involved with Transcendental Meditation asked him to study their responses to stress. Electrodes were attached to their chests and scalps to measure their heart waves and brain waves. Masks collected their breath as they exhaled, so their metabolism and rate of breathing could be measured. Then baseline measurements were taken while they sat quietly for 20 minutes. The same measurements were taken again while they meditated for 20 minutes, and then one last time while they sat quietly without meditating. The individuals had a 17 percent decrease in their metabolism during meditation, and a 20 percent drop in their rate of breathing. Also the frequencies of brain waves were lowered.

Benson identified two basic components of Transcendental Meditation: meditation and prayers involving the repetition of a word, sound, or movement with the out-breath; and passively setting aside other thoughts when they come to mind and returning to the repetition.

When he studied various religions and cultures, he found these essential elements in virtually every one of them. The earliest account was in Hinduism, where there were accounts of individuals focusing on their breathing and repeating a phrase of scripture while disregarding every-day thoughts. The pattern was found in Judaism, Christianity, Islam, Shintoism, Taoism, and Confucianism. He posited that this practice may be conducive to improved health perhaps by reducing parasympathetic nervous system responses to stress, known as the “fight or flight response”.*

Benson sees his work not as alternative medicine but rather as one leg of a three-legged stool. In his words: “One leg is pharmaceuticals, another leg is surgery and other procedures, and the third is self-care. That last leg includes nutrition, exercise, and the relaxation response. It’s vital not to neglect the last leg, because 60 to 90 percent of visits to doctors are for conditions related to stress, where employing pharmaceuticals and surgery is not effective.” (2)

Benson also found out that as much as faith inspires prayer, this form of prayer or meditation inspires health. He and his colleagues treated such conditions as hypertension and cardiac arrhythmia with the relaxation response, the common ingredient in his self-care program and prayer/meditation practices. They cured 75 percent of insomniacs, treated symptoms of depression in people with AIDS and cancer, and relieved nausea and vomiting related to chemotherapy. In a fertility program for infertile women that emphasizes self-care through relaxation response techniques, proper nutrition, and re-framing thinking patterns, 34 percent become pregnant in contrast to 15 percent in other programs.

Dr. David Larson

Psychiatrist David Larson is the president of the National Institute of Healthcare Research and author of the teaching workbook, The Forgotten Factor (co-authored with his wife Susan). In this book, he discusses the relationship between religion and health. Numbers supporting his work come from Gallup polls showing that 95 percent of Americans believe in God, and that although half believe in Hell, 80 percent sanguinely trust in a forgiving God. In addition, 40 percent of Americans attend worship services weekly.

During his psychiatric residency at Duke University, Larson asked a professor for some guidance on how to bring his faith into psychiatric practice. The response was: “Are you the type person who wants people to believe like you do?” Although he said he was not, the professor continued: “It is obvious you are going to hurt your patients.” He recalls that anyone who would bring up that subject would be quickly labeled as a fundamentalist.(3) But his later research and extensive publications have brought attention, which helped fund the National Institute for Healthcare Research. The Faith in Medicine program, which the institution funds, gives $10,000 grants to medical schools for courses on religion and health. Johns Hopkins and George Washington University are among the eleven schools that have received the grants.

Dr. Harold Koenig

Among the pioneers of the study of faith’s healing potential is Harold Koenig, an associate professor of psychiatry and director of the Center for the Study of Religion, Spirituality, and Health at Duke University Medical Center. Koenig first noticed the significance of faith as a factor in medical recovery when he was a young family doctor. He was consulted about a patient who had been hospitalized for a month after hip surgery. Her husband had died of a sudden stroke, and she had slipped on ice at his funeral and fractured her hip. The surgeon warned him that she was emotionally vulnerable. Indeed, she had experienced events that normally would trigger clinical depression and thus undermine her recovery.

He was therefore surprised to find the old lady cheerful when he entered her room. She said: “What can I do for you, Doctor?” Koenig’s search for obvious signs of depression-fatigue, darkened or tear-reddened eyes, difficulty concentrating-indicated nothing. Upon further conversation, he discovered that she maintained her cheerful mood by reading the Bible. She told him: “If I wake up alone or afraid, I read my Bible or talk to God. He is always there, even when my loved ones are not. It’s the most important thing that keeps me going.”

Koenig was impressed. When she recovered with few complications, he felt compelled to study further the medical significance of such deep faith. Since that event, numerous patients have told him how their faith helped them cope, thus speeding their physical healing. His research team, which has studied thousands of Americans since 1984, has compiled powerful evidence that religious faith not only promotes overall good health, but also helps patients recover from serious illness.(4)

“By praying to God, patients acquire an indirect form of control over their illness.” They believe they are not alone in their struggle, and that God is personally interested in them. This safeguards them against the psychological isolation that batters so many seriously ill people. In a study of 455 elderly hospital patients, Koenig found that people who attended church more than once a week averaged about four days in the hospital. People who never or rarely attended church spent about ten to twelve days of hospitalization.

Dr. Dale Matthews

Dale Matthews is an associate professor of medicine at Georgetown University Medical Center, Washington, DC. As a young internist in the early 1980s, he met a patient with strong faith who would make a lasting impact on his life. The man said: “I am a devout Christian. If you’re going to be my doctor, I want you to pray with me” before allowing Matthews to treat him. Matthews had never shared his own faith with his patients, so at first he was reluctant. But nevertheless he joined hands with the man, who he hoped would keep quiet and keep the matter secret. After all, he did not want to be labeled “unscientific.” He was alarmed when the man’s booming voice filled the examination room. But Matthews had a crucial realization that day: His patient was a whole person, not a composite of symptoms and tests forming a “case.” This led him to become sensitive to signals indicating that religion is important to a patient. If someone says: “I hope from God that nothing bad shows up in these tests,” Matthews will say: “Tell me your thoughts about God.” He declares: “We cannot prove scientifically that God heals, but I believe we can prove that belief in God has a beneficial effect.” In his recently published book The Faith Factor, he incorporates religious wisdom, scientific research, and patients’ stories to make a case for the faith-health connection.(5)

Statistical Findings

Health care institutions are beginning to pay attention to the faith-health connection. Harvard Medical School, the Mayo Clinic, and the AAAS have sponsored conferences on spirituality and health. Nearly half of all American medical schools now offer courses on the topic. Below we give findings of some published studies on the topic.

• In a survey of 269 doctors at the 1996 meeting of the American Academy of Family Physicians, 99 percent said they thought religious beliefs could contribute to healing. When asked about their personal experiences, 63 percent of doctors said God intervened to improve their own medical conditions. Their patients agree even more enthusiastically that prayer is a powerful tool in healing. Polls by Time/CNN and USA Weekend show that about 80 percent of Americans believe spiritual faith or prayer can help people recover from illness or injury, and more than 60 percent think doctors should talk to patients about faith and even pray with those who request it.

• According to researchers at Columbia University, children whose religiously committed mothers are less likely to suffer from depression later in life.(6) In their study, 60 mothers and 151 children were followed over 10 years to determine if there was any relationship between a mother’s religious commitment and resulting depression in her children. The study found that daughters, but not sons, of women who considered religion to be highly important were 60 percent less likely to have a major depressive disorder at the 10-year followup. A second important factor linked with less depression was the degree to which the children embraced their mother’s religion. When the mother and child were members of the same religious denomination at the followup, daughters were 71 percent less likely to suffer from a major depressive disorder while sons were 84 percent less likely.

• Another significant finding of the study was that highly religious mothers were less likely to be depressed themselves.(7) Women for whom religion was highly important were 81 percent less likely to have major depression at the 10-year followup. This finding is consistent with other studies showing an inverse relationship between religiosity and depression. Several possible explanations exist for these findings. According to the researchers, highly religious mothers also were less likely to be divorced or exhibit poor social functioning—-both of which could contribute to depression in children. Another potential explanation comes from a recent study at the Medical College of Virginia, which found that religion can protect people from depression by buffering them against stressful life events.(8)

• A Dartmouth Medical School study found that heart patients were 14 times more likely to die following surgery if they did not participate in group activities and did not find comfort in religion. Within six months of surgery 21 patients died, but there were no deaths among 37 people who said they were “deeply religious.”

• A Yale University study of 2,812 elderly people found that those who never or rarely attended church had nearly twice the stroke rate of weekly church-goers.

• A survey of 5,286 Californians found that church members have lower death rates than nonmembers—regardless of such risk factors as smoking, drinking, obesity, and inactivity.

• Those with a religious commitment had fewer symptoms or had better health outcomes in seven out of eight cancer studies, four out of five blood pressure studies, four out of six heart disease studies, and four out of five general health studies. According to one research analysis, people with a strong religious commitment seem to be less prone to depression, suicide, alcoholism, and other addictions.

• Can others’ prayers help? In a 1988 study by cardiologists Randolph Byrd, 393 heart patients in San Francisco General Hospital Medical center were divided into two groups. One was prayed for by people around the country; the other did not receive any prayers from study participants. Patients did not know to which group they belonged. The group that was prayed for experienced fewer complications, fewer cases of pneumonia, fewer cardiac arrests, less congestive heart failure, and needed fewer antibiotics.(9)

• Researchers studying a sample population of 2,730 drawn from the Alameda County Study—a long-term research project of health and mortality—found that people who both attend religious services and participate in other activities through their place of worship receive protection from the stress of financial burdens, health issues, and other problems.

• In a study of nearly 600 severely ill hospital patients aged 55 and older, researchers measured 47 ways of coping. They discovered that patients who sought a connection with a benevolent God as well as support from clergy and church members were less depressed and rated their quality of life as higher, even after taking into account the severity of their diagnosis. Researchers also found that patients who gave spiritual support to others by praying for them or encouraging their faith also faired better emotionally.

• Another recent study conducted at Duke University revealed more striking results. In the first study to examine the role of religion in recovering from depression, researchers followed 87 patients aged 60 or older who were diagnosed with depressive disorder after being admitted to the hospital for a physical illness. They discovered that religion can help people recover from depression. In fact, the more spiritual the patient, the more quickly he or she recovered.(10)

Conclusion

Can faith really heal? According to some researchers, the answer is a definite yes. The study of the link between religious faith and physical healing is very young. But there are important signs that faith can have significant positive impact on health, complementing such conventional medical practices as pharmaceuticals and surgery. Increasingly, professionals from respected institutions are looking into the relationship of faith and healing via scientific methods. Once considered a taboo, studying the healing powers of faith is now taken seriously in scientific circles. Regardless of its results, the very existence of this effort promises to expand the possibilities of cooperation between science and faith, and lead to a better understanding of human nature. *Fight or Flight Response: Stress has been defined as the perception of threat or danger that requires behavioral change. Stress results in various bodily changes, including increased metabolism, and increases in heart rate, blood pressure, breathing rate, and blood flow to the muscles. These internal physiological changes prepare us to fight or run away, and thus stress reaction has been named the “fight or flight” response. The fight or flight response was first described by Harvard physiologist Dr. Walter B. Cannon. It is mediated by the increased release of adrenaline and noradrenalin (epinephrine and norepinephrine) into the blood stream.

References

1. Herbert Benson, Timeless Healing: The Power and Biology of Belief (Fireside: 1997).
2. “Mindful Healing, Technology Review,” Edited by Massachusetts Institute of Technology, October 1996.
3. Jessica Cohen, “The Greatest Story Never Told,” Utne Reader, No. 80, April 1997.
4. “Doctors Report: Faith Can Heal You,” Reader’s Digest, October 1998.
5. Dale A. Matthews, The Faith Factor: Proof of the Healing Power of Prayer, Penguin USA, 1999.
6. L. Miller, et al. “Religiosity and Depression: Ten-year Follow-up of Depressed Mothers and Offspring.” J. Am. Acad. Child Adolescent Psychiatry 1997; 36:10:1416-1425.
7. Ibid.
8. K. S. Kendler, et al. “Religion, Psychopathology, and Substance Use and Abuse: A Multi-measure, Genetic-Epidemiologic Study.” Am. J Psychiatry 1997; 154(3):322-329.
9. “Doctors Report: Faith Can Heal You,” Reader’s Digest, October 1998.
10. “Why Doctors Believe Faith is Powerful Medicine,” Reader’s Digest, October 1999.
11. http://www.nihr.org/media2/99_apr_stress.html