For
the first post, each group will learn some information about each person’s
family of origin. This should aid each group in beginning to imagine their
respective adoptee. While some of the information may at first appear to be
unrelated to our subject of study, life-span issues for individuals with
disabilities, fear not. It will all make sense as we move through the semester.
Khalid Nassar – Week One
The Nassar family moved to the United States just one week
before the overthrow of the regime in their native Iraq. They later learned
that most of their family had been killed by a gang of armed men who claimed to
be representing a political faction different from that in the Nassar’s small
town. They brought with them two daughters and a son, and Mrs. Nassar had just
learned that she was pregnant. She was at once joyous and in despair as she
began to realize that she would never see her father and mother again. Mr.
Nassar found a job driving a delivery truck, and the family lived in a small
house that was adjacent to the town’s housing projects. Mrs. Nassar did not
adjust well to life in the U.S., and she cried constantly. She would go for
days without eating, and most days it was hard just to get out of bed. The
girls were in school, and the little boy spent most of his time with some kids
on his street. Add to it the fact that she felt unwelcome in her town owing to,
she thought, her full head covering that was part of her religious observation.
What might be going on for Mrs. Nassar with
regard to her mental health?
Are there medications that could help Mrs.
Nassar that are safe to take during pregnancy?
How is it that someone who is a strict Muslim might approach such symptoms? Would she be more or less likely to seek Western psychiatric treatment given her cultural background?
What might be going on for Mrs. Nassar with regard to her mental health?
ReplyDeleteThe Nassar family as a whole has been through an intense sequence of events that would be enough to alter the mental health of any person. For Mrs. Nassar it almost seems as if all the major events in her life are working against her at the moment. Being relocated to an area that is very foreign to you with customs, traditions and appearances of an entirely different culture can bring on a state of shock and loneliness which is enough for many people to become depressed when they realize that their lives are no longer what they once were. (Costello, 1982) Since Mrs. Nassar’s culture and religious beliefs require that women are fully covered makes her blending into her new surroundings extremely hard; this in turn may make her feel even more isolated from her new society and may cause her to draw back from her family as well. Feelings of loneliness can very easily lead to depression when they are aided by isolation from your family.
In the case of Mrs. Nassar’s mental health, it seems that her drastic culture change wasn’t the only traumatic event that may have negatively affected her mental health. Since the Nassar family had also recently learned that their family was killed in Iraq, just a week after they left, has brought Mrs. Nassar to a deep state of mourning; which in combination with the loneliness and isolation has now significantly increased her risk of developing depression.
What’s more, when Mrs. Nassar discovered that she was pregnant, her excitement may have been present, but not as apparent considering her state of mourning over the loss of her family. It has also been found that reproductive hormones can cause depression to worsen, which can only make everything even more difficult to cope with. Depression may occur in women at different phases of their reproductive cycle. It has also been found that pregnancy may cause depression in women, but depression is more common during their child bearing years (Noble, 2005). Studies have also shown that depression more often occurs in women between the ages of 25 and 40, who are married and have children-- which are characteristics that seem to describe Mrs. Nassar very well (Paykel, 1991).
Depression in women can be caused by any single circumstance such as mourning, isolation, loneliness and reproductive hormones, but having all of these circumstances all occurring in one’s life at one time can cause an individual to be severely at risk of becoming depressed. Since everything happening in Mrs. Nassar’s life at the moment are very popular causes of depression ad along with the other symptoms that she has recently displayed (constant crying, not eating and not even being able to get out of bed some day) brings us to the conclusion that Mrs. Nassar’s mental health is in a very fragile and poor state, which at this point is in need of medical attention since her mental health may affect her unborn child (Petrillo, 2008).
Costello, C. G. (1982). Social Factors Associated with Depression: A Retrospective Community Study. Retrieved from http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=5216712.
Noble, R. E. (2005). Depression in Women. Retrieved from http://www.sciencedirect.com/science/article/pii/S0026049505000363.
Paykel, E. S. (1991). Depression in Women. Retrieved from http://psycnet.apa.org/psycinfo/1991-30546-001.
Petrillo, L. (2008). Untreated Maternal Depression: What is the Impact on the Unborn Child?. Retrieved from http://www.womensmentalhealth.org/posts/untreated-maternal-depression-what-is-the-impact-on-the-unborn-child/.
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ReplyDeleteAre there medications that could help Mrs. Nassar that are safe to take during pregnancy?
ReplyDeleteThe decision of which treatment to use for depression during the pregnancy period is complex. Treatment decision is complex due to the uncertainty of risks, reproductive outcomes, and women’s preferences and values. Recent reports of drawbacks associated with the use of some commonly used antidepressants makes the management of depression during pregnancy even more complex. Due to the lack of quality information, delaying medication use until after birth is the safest option. However, doing so may not be best for Mrs. Nassar, the family, or the fetus, because untreated depression in pregnancy may raise more risks. Other risk factors in Mrs. Nassar’s household such as assimilating to American culture, poverty, and dealing with her other children may cause a great deal of stress without medication. Problems that were reported as being associated with untreated depression include poor self-care, preterm birth, abnormal neurochemical changes in offspring, and poorer behavioral and mental health outcomes in children (Patal & Wisner, 2011).
Although untreated depression is very serious issue for Mrs. Nassar, antidepressants carry many risks for her throughout her pregnancy period. The evidence to date suggests that the safety of antidepressants may vary by trimester of exposure, class of antidepressant, length of use, and dose. Effects can also be both short and long-term. In general the use of the newer antidepressants, particularly the serotonin reuptake inhibitors (SSRIs), are recommended because more data is available about their safety. A study of depressed pregnant women taking antidepressants found significantly higher rates of preterm birth in those who received antidepressants, compared to women with no or partial treatment as well as healthy women. The use of medication in the first trimester has also been associated with increased risk of miscarriage, therefore, waiting to start an antidepressant until after the first trimester will minimize the risk.
After an in-depth discussion of available options, Mrs. Nassar may choose to use antidepressants, receive counseling, or use a combination of both methods. If Mrs. Nassar makes the decision that medication is needed, there are a number of available antidepressants from which to choose. SSRIs are most commonly used in the treatment of depression, and among SSRIs, paroxetine (Paxil), sertraline (Zoloft), and fluoxetine (Prozac) have been studied most. Some authorities recommend Zoloft as the preferred first-line agent in pregnancy, but it is not risk-free. It has been reported to increase the risk of cardiac septal defects, but the absolute risk appears to be small (Hackley, 2010).
Hackley, B. (2010). Antidepressant medication use in pregnancy. Journal of Midwifery &
Women’s Health, 55 (2), 90-97.
Patel, S. R., Wisner, K. L. (2011). Decision making for depression treatment during pregnancy
and the postpartum period. Depression and Anxiety, 28 (7), (589-595).
How is it that someone who is a strict Muslim might approach such symptoms?
ReplyDeleteMrs. Nassar and her family are devout Muslims living in the United States, which might make practicing their religion difficult at times. After leaving Iraq Mrs. Nassar feels out of place, especially while around town in her native headdress. One place Mrs. Nassar might feel most comfortable is in the safety of her own home. Prayer is an integral part of the Muslim faith. Practicing prayer in her home is an approach Mrs. Nassar might consider trying as treatment for her depressed taste of mind. In the Islamic faith; Muslims perform “duas” which is the act of supplication. Muslims regard this as a profound act of worship. Many narrations from the collections of hadeeth provide the Muslims with duas for a wide range of situations and circumstances they may find themselves in (Varma, 2011). Mrs. Nassar was first excited with the news of her pregnancy but with all other factors in her life considered, her happiness soon turned into despair. When praying to Allah, the highest God, it is essential to have sincerity and true intentions when asking for help. So while performing her duas, Mrs. Nassar must tap into that joy she once had for her pregnancy, in hopes that Allah will answer her prayer.
In the Muslim faith people believe there are reasons other than medical explanations for depression and other health issues. A few of the reasons Muslims believe people develop depression are: by thinking negatively, wiping your hands or face of your clothes, and recalling old memories. Mrs. Nassar is missing her family so she is most likely recalling old memories of her life in their native Iraq. She also knows she will be unable to see her family again and she has anger for the people who came into her town and killed her loved ones, so she is experiencing negative thoughts. In addition to Muslims having a list of explanations for depression, they also have a list of remedies. They believe that diet has a large impact on health, they recommend using raw vegetables in meals, eating oranges, berries, black grapes, and olives. Muslims also recommend eating dry fruits before meals, and drinking warm milk with honey and cinnamon powder. In addition to changing their diet Muslims also believe in order to be rid of depression you need to keep a positive attitude toward others even if they do not show a friendly attitude toward you.
Other recommendations for depression is to recite Bismillah Hir Rahman Ir Rahim Lahaula Wala Quwata Illa Billah Il Ali Ul Azim 100 times, (“Health Remedies” ,1999, para. 17&18) and when you wake up from sleep to recite Durud five times and Lahual eight times, while lying down. It is then recommended to recite Durud five times and Luhaul eight times while in a sitting position, and once again while standing. If Mrs. Nassar completes these prayers in the morning while getting up, it might help her start her day and make it easier for her to get out of bed.
Since Mrs. Nassar is a strict Muslim, she will likely want to raise her family with the same beliefs. Praying and changing her thought pattern, as well as her diet, to help benefit her mental health would be a better example for her children than using Western Medicine.
Health Remedies. (1999). Duas. Retrieved from http://www.duas.org/healthremedies.htm.
Varma, R. (2011). Duas. Retrieved from http://www.haqislam.org/articles/duas/.
Would she be more or less likely to seek Western psychiatric treatment given her cultural background?
ReplyDeleteMrs. Nassar like many other individuals of her cultural background unfortunately find that emerging into the Western culture can be an exhausting experience. More often than not, those of Muslim culture may undergo persistent social exclusion, which often results in the hindering of an individual’s self esteem and psychological health. In the case of Mrs. Nassar, depression is the illness at hand. Being a woman of Muslim culture in the United States, Mrs. Nassar would be less likely to seek Western psychiatric treatment. Muslim cultural views differ from that of Western views in the area of mental illness. In the United States psychiatric illnesses are said to be treatable through means of prescribed medications at times in combination with behavioral therapies. Western society tends to represent religion and medicine or religion and science as two very separate entities, but from a Muslim viewpoint the two go hand in hand. Historically Muslims found the Qur’an to be a healing source when an individual is suffering from psychological or spiritual illness, while antidepressants are often the choice of treatment for those suffering from depression in Western Society. For Mrs. Nassar medications do not coincide with her faith and spiritual beliefs. As a strict Muslim, Mrs. Nassar would likely prefer a more therapeutic strategy that would fit into her strong religious beliefs rather than contradict them.
In more recent times some individuals of Muslim culture have considered surgical and medical treatments as necessary, however they still take into account their cultural obligations and beliefs. It is Muslim belief and Muslim practice to prevent the need of medical treatment by living and faithful life. Many of those that live by these cultural ways believe in eliminating disease and illness by living healthy lives, thus including, maintaining good hygiene, having dietary restrictions, and avoiding addictive behaviors. (Taheri, 2008) If Western society would stress and incorporate living healthy physically as well as mentally and work to eliminate environmental and societal factors that affect one’s self- worth they would be inviting the Muslim cultural views in and diminishing the likelihood of mental illness for many. Seeking treatment from a drug alone is an option Mrs. Nassar as a strict Muslim would never do. According to Ahmad Yousif of Islamic Medicine and healthcare, “Drugs can never remove the causes of loneliness, estrangement of family members, or lack of self-worth—but Islamic medicine can.” (2002) Muslim cultural beliefs grant Allah complete control when it comes to birth, life, illness and death. With illness and disease there is no negative connotation, all that happens to an individual is intended to be an experience granted by God, thus Mrs. Nassar would likely seek health through prayer and faith in Allah.
Taheri, N. (2008, May 1). Health Care in Islamic History and Experience. EthnoMed, Retrieved from http://ethnomed.org/cross-cultural-health/religion/health-care-in-islamic-history-and-experience
Yousif, A. F. (2002, February). Islamic Medicine and Health Care. Bulletin, (25), 1-16. Retrieved from http://www.parkridgecenter.org