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Anxiety Help From a Muslim Therapist
About Aisha Chaudhry
Aisha Chaudhry is an Aalimah and Muslim Therapist. She specializes in trauma which often looks like depression, anxiety including OCD, intrusive thoughts, health anxiety, and panic. She has a special interest in helping clients learn how to calm the body through a combination of neural informed therapies, Internal Family Systems, CBT, and Exposure-Response Prevention. For clients looking for integrated therapy, a holistic approach is available.
Table of Contents
Anxiety Help from a Muslim Therapist
The information contained herein is to offer a comprehensive overview of anxiety (not for treatment or diagnosis) with special emphasis on what anxiety often looks like in some of the Muslim populations, particularly Muslim women I treat. It is important to get anxiety help from a Muslim therapist, particularly, one who has studied Islam and who knows the Islamic rulings surrounding the issues clients seek treatment for. Getting help for anxiety from a Muslim therapist will be beneficial because:
- Therapeutic Alliance: It is important for the client to develop a good therapeutic relationship with the therapist. This can only happen if the client feels safe enough to discuss matters that they feel embarrassed about or fear they may be judged negatively due to them. Sometimes the themes related to the obsessions are very difficult to communicate to anyone, which is one of the reasons for lack of seeking care at all. Additionally, to help the client feel comfortable with the treatment plan, the therapist should be comfortable with Islam and various Muslim cultures. The topics that often come up for Muslim populations are often related to what they value most, and often that is religious-oriented themes and contamination issues related Islam, culture, and legacy.
- Accurate Diagnosing. What Anxiety looks like among the Muslim population can significantly vary from other populations, which can cause a condition to either go undiagnosed or even misdiagnosed. Sometimes Muslims may seem to be more religious, have more piety (taqwa) or engage in more rituals to reduce anxiety. Behaviors may or may not reflect an accurate depiction.
What is Anxiety?
Anxiety and worry are normal reactions to stress and can be beneficial in some situations. It can alert us to dangers and help us prepare and pay attention and respond with energy needed. Anxiety disorders differ from normal feelings of nervousness or anxiousness and involve excessive fear or anxiety. Anxiety disorders are the most common of mental disorders and affect nearly 30% of adults at some point in their lives. But anxiety disorders are treatable and a number of effective treatments are available. Treatment helps most people lead normal productive lives. Anxiety help from a Muslim therapist will be exponentially beneficial because of helping you do what you already are doing, but in a way that will bring further relief in sha Allah.
There are many different types of anxiety and anxiety spectrum disorders.
- Obsessive-Compulsive Disorder
- Specific Phobia
- Social Anxiety Disorder
- Panic Disorder
- Agoraphobia
- Generalized Anxiety Disorder
- Separation Anxiety Disorder
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Women are more likely than men to experience anxiety disorders.
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Anxiety refers to the anticipation of a future concern and is more associated with muscle tension and avoidance behavior. Sometimes avoidance behavior looks like keeping busy to distract which is again to avoid the original stressor or perceived threat.
Fear is an emotional response to an immediate threat and is more associated with a fight or flight reaction – either staying to fight or leaving to escape danger. Some may also freeze or do nothing while in fear.
The causes of anxiety disorders are currently unknown but likely involve a combination of factors including genetic, environmental, psychological and developmental. Anxiety disorders can run in families, suggesting that a combination of genes and environmental stresses can produce the disorders.
Anxiety disorders can cause people to try to avoid situations that trigger or worsen their symptoms. Job performance, school work and personal relationships can be affected. In general, for a person to be diagnosed with an anxiety disorder, the fear or anxiety must:
- Be out of proportion to the situation or age-inappropriate
- Hinder ability to function normally
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Common Types of Anxiety
Generalized anxiety disorder involves persistent and excessive worry that interferes with daily activities. This ongoing worry and tension may be accompanied by physical symptoms, such as restlessness, feeling on edge or easily fatigued, difficulty concentrating, muscle tension or problems sleeping. Often the worries focus on everyday things such as job responsibilities, family health or minor matters such as chores, car repairs, or appointments.
OCD is an anxiety spectrum disorder where an individual most likely had anxiety around a particular theme, which then progressed into an obsession, and as a result started avoiding or doing different things to relieve the anxiety surrounding the fear.
This is a separate topic. Read here about it in comprehensive detail.
The core symptom of panic disorder is recurrent panic attacks, an overwhelming combination of physical and psychological distress. During an attack several of these symptoms occur in combination:
- Palpitations, pounding heart or rapid heart rate
- Sweating
- Trembling or shaking
- Feeling of shortness of breath or smothering sensations
- Chest pain
- Feeling dizzy, light-headed or faint
- Feeling of choking
- Numbness or tingling
- Chills or hot flashes
- Nausea or abdominal pains
- Feeling detached
- Fear of losing control
- Fear of dying
Because the symptoms are so severe, many people who experience a panic attack may believe they are having a heart attack or other life-threatening illness. They may go to a hospital emergency department. Panic attacks may be expected, such as a response to a feared object, or unexpected, apparently occurring for no reason. The mean age for onset of panic disorder is 20-24. Panic attacks may occur with other mental disorders such as depression or PTSD.
A person with social anxiety disorder has significant anxiety and discomfort about being embarrassed, humiliated, rejected or looked down on in social interactions. People with this disorder will try to avoid the situation or endure it with great anxiety. Common examples are extreme fear of public speaking, meeting new people or eating/drinking in public. The fear or anxiety causes problems with daily functioning and lasts at least six months.
A specific phobia is excessive and persistent fear of a specific object, situation or activity that is generally not harmful. Patients know their fear is excessive, but they can’t overcome it. These fears cause such distress that some people go to extreme lengths to avoid what they fear. Examples are public speaking, fear of flying or fear of spiders.
Agoraphobia is the fear of being in situations where escape may be difficult or embarrassing, or help might not be available in the event of panic symptoms. The fear is out of proportion to the actual situation and lasts generally six months or more and causes problems in functioning. A person with agoraphobia experiences this fear in two or more of the following situations:
- Using public transportation
- Being in open spaces
- Being in enclosed places
- Standing in line or being in a crowd
- Being outside the home alone
The individual actively avoids the situation, requires a companion or endures with intense fear or anxiety. Untreated agoraphobia can become so serious that a person may be unable to leave the house. A person can only be diagnosed with agoraphobia if the fear is intensely upsetting, or if it significantly interferes with normal daily activities.
A person with separation anxiety disorder is excessively fearful or anxious about separation from those with whom he or she is attached. The feeling is beyond what is appropriate for the person’s age, persists (at least four weeks in children and six months in adults) and causes problems functioning. A person with separation anxiety disorder may be persistently worried about losing the person closest to him or her, may be reluctant or refuse to go out or sleep away from home or without that person, or may experience nightmares about separation. Physical symptoms of distress often develop in childhood, but symptoms can carry though adulthood.
Selective Mutism is a related disorder which often develops in children but can also appear in adults, particularly if it was present as a child and was untreated.
Children with selective mutism do not speak in some social situations where they are expected to speak, such as school, even though they speak in other situations. They will speak in their home around immediate family members, but often will not speak even in front of others, such as close friends or grandparents.
The lack of speech may interfere with social communication, although children with this disorder sometimes use non-spoken or nonverbal means (e.g., grunting, pointing, writing). The lack of speech can also have significant consequences in school, leading to academic problems and social isolation. Many children with selective mutism also experience excessive shyness, fear of social embarrassment and high social anxiety. However, they typically have normal language skills.
Selective mutism usually begins before age 5, but it may not be formally identified until the child enters school. Many children will outgrow selective mutism. For children who also have social anxiety disorder, selective mutism may disappear, but symptoms of social anxiety disorder may remain.
This is a related disorder. Please read more in detail about this disorder here:
What Individuals With Anxiety Say
Anxiety can appear at any time and age in an individual’s life. Of course there are risk factors such as genetic predispositions, environment, and life stressors.
Clients often say things like:
- I worry about a lot of different things like how what if something happens to my loved one or my job.
- I am deathly afraid of __________ and can hardly think to go near it.
- I am worried about having bad thoughts that I might be punished by Allah about.
- When I’m in a particular situation or stressed, I find I cannot even speak.
- Sometimes I feel like I may have a heart attack or suffocate.
- I feel tense and sometimes dizzy.
- I have a lot of different pains in my body.
- I feel like my heart is racing.
- I pace around and sometimes talk fast.
- When I have to speak in front of others, I feel so nervous that I may faint.
- I have fainted from public speaking.
- When I’m around a particular person or situation, I get knots in my stomach.
- I fear I am going to mess up and embarrass myself.
- I get so nervous before exams and am sure I am going to fail because of it.
Don't Believe Everything You Think
Just because you think it or fear it does not make it true. Sometimes the brain has a stubborn desire to hold on to a particular belief, particular if the stakes seem high. And sometimes it’s as though images of random frightening or repulsive things flash through the mind. What do you say about yourself when these thoughts and images come? It is hard to bear, so we go into overdrive to stop it all.
Anxiety can come due to real or perceived threats. It’s important to help the body learn which it is experiencing.
Those inner thoughts can feel like a bully or the voice of an inner critic. Aisha can help you learn how to take charge of your thoughts instead of thoughts taking charge of you, your life, and your family’s life.
Am I a Bad Muslim?
When clients ask me if they are a bad Muslim because they are afraid, a part of my heart breaks. Sometimes people believe they are bad Muslims because of having fear for things or people other than Allah swt. Sometimes Muslims are shamed and are told they are less of a Muslim because of what they are experiencing. Anxiety help from a Muslim therapist will be exponentially beneficial because of helping you understand anxiety from a broader perspective that doesn’t cause shame and actually brings relief in sha Allah.
Truth be told, Anxiety serves great purposes. It lets us know there is something to be careful about. It is by divine design that we have a fantastic way of staying safe! The brain has learned that it needs to sign off some alarms to keep you safe, and sometimes those alarms get paired with different situations, and sometimes there is a faulty connection but the goal is still to keep you safe. When the brain has a hard time deciphering between real and perceived threats, we develop symptoms even when there isn’t anything to be worried about.
“Abu Hurairah (ra) said; His companion came to him and said; Messenger of Allah (saw)! We have thoughts that we cannot dare talk about and we do not like that we have them or talk about them. He said: Have you experienced that? They replied: yes. He said: that is clear faith.” [Abu-Dawood: 5111].
For this reason, we have to take the whole person into consideration along with the thought and behavior processes. Getting help with Anxiety from a Muslim therapist will help because as Muslims, we can decipher between excessiveness, rigidity, and what kinds of fear and how to resolve it in a holistic way you’re comfortable with.
Please keep in mind, that I usually get a lot of background information and then analyze it in totality to help you determine if you are a very pious person or if you are unfairly excessive in one area. I absolutely do not judge and wholeheartedly invite you to explore this. Understanding Anxiety often needs help.
- When you have the thought, how distressing is it?
- Does your mind try to write one outcome and ignore perspectives and possibilities? Pain in one area means you might have cancer for example.
- When you don’t engage in something, how does that affect you.
- Are you engaging in safety behaviors such as avoiding, seeking reassurance, checking, repeating, etc? Ask yourself what do you do as a result of these thoughts?
- Are people at work, school, family, or social domains noticing something may not be ok or perhaps suggesting you should talk to someone?
- Are you asking other people to engage in your safety behaviors or rituals (to make sure everything will be ok)?
- Do you spend a lot of time trying to get through the distressing thoughts or situations?
- Would you say that you are equally pious in other areas of your life except for these couple of things? For example, a person does not eat halal, zabiha food regularly or doesn’t mind that much but on the other hand struggle with prayers or wudhu and is overly meticulous in comparison.
- Are others feeling it is really difficult to live and be around you?
Diagnosing Anxiety
To diagnose Anxiety, I use the criteria specified by the American Psychiatric Association (APA). Additionally, I use one or more assessment instruments to create a baseline of symptoms and their severity. This helps us know where we are starting so that we know if we are progressing. However, as a Muslim therapist who has experience in treating Anxiety, I will look at the totality of a person in relation to religious practices. Not all clinicians will know without lengthy explanations on what would be considered excessive or creating a hardship for oneself.
Because there are many types of Anxiety, it will be difficult to list the diagnostic criteria. Most people know if they have something like too much worry or distress. If you are worried about things and are having trouble managing that worry, schedule an appointment to get it checked out.
Treating Anxiety & Related
Clients with Anxiety who seek treatment will often experience improvements in their quality of life across all domains. For example, people who were previously late, lacking in focus, losing relationships, avoiding events, struggling in relationships etc may notice they improve their functioning and are able to reengage in areas of life they value and improve relationships with people and relationships to ideologies that often help them even improve their spirituality and relationship with Allah swt.
Several types of therapies may be used to help clients with Anxiety. As a Muslim therapist dealing with Muslim clients, per my client’s comfort levels, I offer an integrated therapy helping them with Islamic principles and values that most find liberating. Please note that clients absolutely have the option of electing therapy without Islamic principles and values.
Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness.
Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications. Anxiety help from a Muslim therapist will be exponentially beneficial because of we’ll be able to reframe your experiences in ways that really make sense to you!
There are many types of modalities or techniques used in CBT, but the technique used to treat Anxiety and Anxiety Spectrum Disorders; among others is Exposure-Response Prevention (ERP). ERP is the gold standard treatment model and is excellent when enhanced or integrated with other therapies like Mindfulness, which includes Acceptance and Commitment Therapy (ACT). Regardless of the integration of other therapies into the mainframe treatment, ERP must be a part of the foundational therapy. The basic principles of ERP include the following:
- Triggers, fears, and safety behaviors are identified and ranked in terms of distress.
- Clients will be exposed to feared situations or images related to their triggers and fears which will elicit anxiety.
- Clients are instructed to avoid trying to seek reassurance or distraction.
- The client must stay exposed to the anxiety provoking situation, while witnessing that nothing terrible is happening as a result of not trying to control, prevent, or alter the feared outcome.
- The mind and body will learn that thoughts are just thoughts and not necessarily reality, which helps the nervous system and mind develop a healthier thought-response pattern.
- Anxiety due to the specified trigger will shift as exposures are repeated and no compulsions, rituals, or safety behaviors are engaged in.
Clients will learn that they can cope without relying on trying to alter, change, or control circumstances and that whatever comes up can be dealt with without engaging in those compulsions, rituals, or safety behaviors. Even if anxiety does come around it, it can be better managed.
A class of medications known as selective serotonin reuptake inhibitors (SSRIs), typically used to treat depression, can also be effective in the treatment of Anxiety. The SSRI dosage used to treat OCD is commonly higher than that used to treat depression or anxious patients. Clients who do not respond to one SSRI medication sometimes respond to another. Other psychiatric medications can also be effective. Noticeable benefit usually takes six to twelve weeks.
Clients with mild to moderate OCD symptoms are typically treated with either CBT or medication depending on patient preference, the client’s cognitive abilities and level of insight, the presence or absence of associated psychiatric conditions, and treatment availability. It is recommended that patients with severe OCD symptoms receive both CBT and medication.
Disclaimer: I am not recommending you take a medication or remove your current medication. Please talk to your prescriber to see if the medications are right for you.
- 7 out of 10 people will likely see a reduction of symptoms when taking medications.
- A higher dose is often necessary before some medications start working for OCD.
- Taking Benzodiazepines like Xanax can become a compulsion. Your brain may learn that the only way to reduce anxiety is to take this type of medication.
- Medication and treatment together can often make a big difference in reducing symptoms of OCD and anxiety.
NOTE: I do not prescribe medication, but I do request clients who are finding treatment too difficult due to the severity to seek help from a psychiatrist for medication suitable while continuing therapy together. My preference as a therapist is to try to improve on your own before seeking medication.
All of the recommended therapies include neural informed components. Some forms or severity of anxiety will not be managed by merely talking about it and reframing. So it is important to include body work as a part of learning to regulate the body response to stressors. Some of this work includes:
- Breathing exercises
- Polyvagal exercises
- Visualization
- Meditation
- Grounding
- EMDR
As a Muslim therapist and Aalimah, I had the pleasure of identifying special practices we can do which are found in the Quran, Sunnah, and are in line with grounded science that can reduce symptoms associated with various anxieties.
I have created an Islamic Based Mindfulness Stress Reduction Program which is a program you can follow at your own pace. During individual sessions, I do integrate these practices per the client’s comfort and desired level.
I take therapeutic interventions like grounding and integrate them Islamically for the holistic nourishment of the heart, body, and soul. The very same principles from science that have powerful effects on the nervous system are used which highlight and encourage your own identity.
Anxiety help from a Muslim therapist will be exponentially beneficial because of helping you do what you already are doing, but in a way that will bring further relief in sha Allah.
Disclaimer
None of the information on this website is intended to diagnose or treat any condition. This information is for educational use only. Please get treatment if you feel you are struggling with different symptoms.