As-salaamu alaikum,
In tonight’s video (link), I talked about Ayyub ﷺ and the medical reality of depression.
Now, I want to get more personal — and more clinical.
What I actually see in the ER
I have worked in emergency and family medicine for over two decades. And I have seen Muslim patients — young Muslims — come into my ER in mental health crisis.
Sometimes they come in because a family member finally forced them to come. And more times than I can count, what I discover when I talk to them privately is this: they knew something was wrong for months. Sometimes longer. And they didn't say anything.
Because they were ashamed.
One young man — who came from a devout family — told me through tears: “My dad says I just need to make more dhikr. He doesn’t believe in depression. He says it’s a Western concept.”
I sat with that for a moment. And then I asked, “Does he believe in cancer?”
He looked at me confused.
I said, “Because both involve the body malfunctioning in ways the person didn’t choose and can’t simply will away. The brain is an organ. When it’s sick, it needs treatment. That’s not weakness. That’s biology.”
He started crying harder. Not because I said something devastating — but because it was the first time anyone had told him he wasn’t broken as a Muslim for being broken as a person. They were tears of relief.
The hadith that provides the perspective
There is a hadith that I return to again and again in these conversations.
The Prophet ﷺ said:
“There is no disease that Allah has created, except that He also has created its remedy.” (Bukhari)
Read that carefully. There is no disease — not some diseases. Not physical diseases only. No disease.
Depression is a disease. It has a remedy. Seeking that remedy is not an act of doubt. It is an act of obedience to the principle that Allah built healing into creation and commanded us to seek it.
The Prophet ﷺ himself sought remedies for illness. He used honey, black seed, cupping. He didn’t tell sick companions to simply make du’a and wait. He pointed them toward healing.
We have to understand that both the disease and the treatment/medicine are elements of the decree of Allah. We simply fight one decree with another.
Du’a and treatment are not in competition. They are partners.
The neuroscience piece — because you deserve to understand your own brain
Here’s what’s actually happening in depression, in terms your biology teacher never taught you in an Islamic context:
The brain has a structure called the hippocampus — involved in memory, learning, and emotional regulation. In chronic depression, the hippocampus can actually shrink. This is measurable on MRI. It’s not metaphor. It’s anatomy.
Serotonin, dopamine, and norepinephrine — neurotransmitters that regulate mood, motivation, and the capacity to feel pleasure — become dysregulated. This is why a depressed person can’t “just decide to feel better.” The machinery that produces that feeling is malfunctioning.
Here’s what’s even more amazing: both therapy and medication have been shown to reverse some of these changes. The hippocampus can regrow. Neuroplasticity is real. Healing is real.
And now the part that should blow you away: dhikr, salah, and connection to community have also been shown to activate the brain’s reward pathways (dopamine) and reduce cortisol, the stress hormone. The spiritual practices Allah gave us have positive, healing neurological effects. This doesn’t reduce them to mere chemistry — it shows that Allah built the healing properties of ibadah into the brain He designed.
Spiritual practice and clinical treatment work in the same direction. They are not in conflict.
What Ayyub teaches us about the long dark
I want to return to Ayyub ﷺ for a moment, because there's a dimension of his story that the video didn’t fully explore.
The scholars note that Ayyub's trial lasted a very long time, close to twenty years. Long enough that many around him grew distant. Long enough that his situation felt permanent. Long enough that hope itself must have felt irrational.
And yet — he kept calling out to Allah. Not with perfect composure. The words he used — massaniya al-durr — “affliction has touched me” — are raw. They’re not a formal supplication. They’re a cry.
What Ayyub teaches us is not that we should be stoic in suffering. It’s that we should be honest in suffering. That we should bring the actual pain to Allah, not a sanitized version of it.
If you are in a dark season right now — if you have been in it for a while — Ayyub’s du’a is yours to make. Bring it to Allah exactly as it is:
أَنِّى مَسَّنِىَ ٱلضُّرُّ وَأَنتَ أَرْحَمُ ٱلرَّٰحِمِينَ
Tonight’s journaling prompts
Prompt 1: The shame audit - Have you ever felt ashamed of struggling emotionally or mentally because of what it might mean about your faith? Where did that message come from?
Prompt 2: The distinction - Looking at your experience right now — is it spiritual dryness, burnout, situational sadness, or something that has lasted longer and feels bigger? Be honest with yourself.
Prompt 3: The barrier - If you've been struggling and haven’t told anyone, what’s the specific thing stopping you? Name it. Is that barrier real, or is it a fear?
Prompt 4: Ayyub’s du’a - After your next salah, say:
أَنِّى مَسَّنِىَ ٱلضُّرُّ وَأَنتَ أَرْحَمُ ٱلرَّٰحِمِينَ
Anni massaniya al-durr wa anta arham al-rahimin. “Hardship has touched me, and You are the Most Merciful of the merciful.” Say it slowly from the depths of your heart. Mean it. This is Ramadan after all, the month where our du’a has even more power. Don’t miss the chance to take advantage of that.
Resources
Khalil Center (khalilcenter.com) — Muslim mental health clinicians who integrate Islamic spiritual care with evidence-based therapy. Telehealth available nationally.
Noor Human Consulting — Muslim therapists, coaching, and counseling with an Islamic framework.
988 Suicide & Crisis Lifeline — Call or text 988 if you or someone you know is in crisis. Available 24/7.
Ihya Ulum al-Din by Imam al-Ghazali — The section on spiritual diseases of the heart is the classical Islamic map of inner suffering. Dense but worth it.
Lost Islamic History podcast, episode on Prophet Ayyub — accessible background on the story and its lessons.
One more thing
If you read tonight’s email and recognized yourself, or a loved one, in it — please don’t close this and move on.
Tell one person. A parent, a friend, a school counselor, a doctor. Just one person. And if it’s someone you love, reach out to them.
You don’t have to have it all figured out before you ask for help. Ayyub didn’t have it figured out. He just called out.
That was enough.
My inbox is open. Just reply.
May Allah lift what is heavy from your heart and give you comfort, ameen.
— Dr. Ali