 I'm going to be talking about some of the early warning signs of mental illness. And it can be helpful to think about this in terms of a person's lifetime. And when do some of those illnesses come up over the course of a person's lifetime? So when we think about children, some of those illnesses that can come up oftentimes are really being screened for by the pediatricians or the family medicine physicians. And so every time you take your child to a well visit or a checkup, they're usually asking you those developmental questions. How are they sleeping? Are they are they walking? Are they making eye contact? And you'll notice usually at that nine month check and that 18 month check, they're probably throwing in some questions to screen for autism spectrum disorder. So they might ask you about how is your child engaging with you? Are they sharing things with you as they're exploring the world? Are they making eye contact? Are they showing any behaviors that might be worrisome? And so at that point in time, if there are concerns, of course, that's when you'd be discussing them with your physician and then they're getting you in with the appropriate specialists. The next disorder that oftentimes comes up is ADHD. Usually it's young children, especially once they are in school. And sometimes it's teachers that are pointing certain things out to parents. Sometimes it's parents themselves, you're bringing those concerns to their child's doctor and wondering if perhaps the reason they're not able to focus might be because of ADHD. And sometimes what can happen too is because so many things impact a person's ability to focus. Things like anxiety oftentimes can really impact a person's ability to focus, to lay down memory and to retrieve memory. And so sometimes you see children also really struggling with anxiety at a young age. And so what that might look like is a child who is excessively fearful. And perhaps it's interfering with their ability to even go to school. And so this is where they're starting to miss days of school, which of course can affect their learning. Sometimes they're more focused on those physical symptoms. They might tell you about a headache that they're having or that their stomach hurts or they don't feel well. They can't go to that activity or go to school. And so that might be a sign that maybe this is actually anxiety. And when my adult patients talk to me about symptoms that they've had over the course of their lifetime, usually as they're kind of thinking back and reflecting when did all of that start, anxiety oftentimes tends to be when they're younger. But when we think about depression, usually that seems to come up around those teenage years. And oftentimes at that age, what depression can look like is when kids aren't interacting with their friends and their family as they used to. So they aren't hanging out with their friends like usual, or they're not spending time with their family like they usually would, you know, maybe they're quitting the basketball team that they've always loved or they used to be an A, B student and now they're starting to pull Cs. So those would be signs that there might be depression going on. And then when we think about, you know, even suicide at times, kids may even be very outright and upfront about that and say that they're having worrisome thoughts about wanting to harm themselves. So of course, you know, those are taken very seriously and you're getting that person into the right care. And then as we go along our timeline over the course of a person's timeline, usually when we think about bipolar disorder, that happens more so those late teenage years, early 20s, and the things that you'd be looking for at that age would be extreme mood shifts. You know, so you'll hear that someone is not, they're not sleeping. They're not really needing to sleep. They've got so much energy. And, you know, their ideas are just bouncing around from one thing to the next. They might be acting in an erratic way. And usually it's noticeable to other people. And then kind of around that same time too, in your early 20s, late 20s, when schizophrenia starts to develop, it's usually around that age as well. And so the things that you'd be looking out for at that age would be delusions when people have sort of a fixed false belief in something. You know, they might start to believe something, you know, very sort of bizarre. And they might be even hallucinating. Sometimes those may not be as noticeable to family. A lot of times what I hear from patients and really from patients' families is that they're noticing that their loved one is really starting to withdraw, and they're starting to act erratic, and they're starting to behave in ways that are much different than before. So as we go along that timeline again, and we think about other disorders that come up, especially as we think about over the course of a woman's lifetime, oftentimes those fluctuations in hormones can be a time where mood disorders come up. So sometimes that's, you know, during puberty, during menarche, sometimes that's postpartum, you know, after you've had a child. And that's when postpartum depression and even postpartum anxiety and psychosis can come up. And the things that you'd be looking out for there are not so much the feeling tired or low energy, which of course would be abnormal after having had a baby, but more so feeling as though you're not really bonding as well with the baby. You're feeling very overwhelmed, crying for no reason. And those would be definitely noticeable to that person, probably to their family as well. And then thinking about, you know, mood shifts that can occur during menopause, that's another time in a woman's lifetime when you can start to notice mood disorders. And then, you know, as we get towards the end of our lifetime, dementia and memory difficulties can come up. And so some of the early warning signs there might be that this person is starting to get lost when they're driving, they're starting to be a little bit more confused about things. They're noticing maybe difficulties with remembering how to do something and completing tasks that they ordinarily would have no trouble doing in the past. They might be misplacing things. Sometimes what people will notice is that that family member is not really interacting as much socially. They're kind of withdrawing because, you know, they're having difficulty keeping up with the conversation. So that sort of in a nutshell is what you can see over the course of a person's lifetime. You know, when did those disorders usually come up? And of course, then the next question is why does mental illness occur? What causes this? And so one of the models that we talk about is what we call a stress diathesis model. And so basically just sort of taking into account that there's likely genetic factors that are at play, but then also environmental triggers that help to bring this mental illness to the surface. So one of the things that we talk about are the three P's in terms of risk factors. So predisposing risk factors, precipitating risk factors, and perpetuating risk factors. So when we think about predisposing risk factors, you know, what are those factors that can predispose someone to mental illness? Genetics, of course, is a big one. So if there's a family history of a mood disorder or substance dependence, that can be handed down in families. And of course, with the stigma that surrounds mental illness, we'll talk about this in a little bit, it can be hard to even get that history from family members. They may not have ever shared that with anyone in the family. And so sometimes as you're maybe speaking with a psychiatrist or a therapist, and they're kind of gathering that history, and you're kind of reflecting on what that person was like, you may sort of start to put the pieces together and realize that maybe this person really did have mental illness, maybe they were depressed, maybe they had an anxiety disorder. So another predisposing factor would be family dynamics and the ways in which families handle conflict that can obviously predispose someone to mental illness. And then that second P, precipitating, what are those precipitating factors that can precipitate mental illness? And those would be things like stressors in the environment, whether it's abuse or neglect or war or poverty, those things can precipitate mental illness, especially as they're sort of placed on top of those predisposing factors. And then what may make it harder to treat are those perpetuating factors, our third P. And that really points to things like ongoing stress or ongoing conflict within that family household or ongoing substance use. So those, it can be helpful to think about those risk factors within that framework. And with that, I think I'll hand it back over to Dr. Rania. Thank you so much, Dr. Rosanna. That was very helpful and informative. And I'm going to kind of dovetail right where you have been talking about, you know, really about these signs and symptoms, what to look out for. And I love how you talked about it from the lifespan, kind of from the beginning until later in life. And the next question that I have to really to discuss here as part of our agenda is if you've been hearing this and wondering what about my role in all of this, whether I'm a parent, whether I be somebody who is a leader in the community, this could be a religious leader, it could be a community leader, it could be a youth leader. There's all different types of folks who might be in leadership positions and are more on the front lines of a community. Or you simply could be a family member, a friend, a loved one to someone else, or maybe it's yourself or your kid. And so each of these roles have certain responsibilities. And there's always a question about what is my task? What should I do if I found that myself or my loved one meets any of the symptoms or criteria that Dr. Rosanna just mentioned? And so what I'm going to share with you a little bit is, you know, how to help answer that question a little bit more. And so we call all of the categories I mentioned stakeholders, people who have a stake in the well-being of their family member, their loved one, or even themselves. And what do you do with these signs and symptoms we just talked about? So here are a couple of steps really to think about. I'm going to talk about five steps. And these are hopefully useful steps in how to address mental health. It's not easy, I'll say that right off the bat. And it's also something that sometimes is, because of the stigma that sometimes surrounds mental health, it may be awkward for some people or they just don't know how to approach it when they know somebody is actually not doing so well. So here are the steps of how you can help. Number one, try to identify a time and a place that's actually appropriate for the conversation. And honestly, this is even with your own children. Of course, if a child is very little, this may not apply quite as much as if they're a teenager or maybe an adult, right? Or just a loved one or a family member. Remember, these conversations are better had in a private setting if possible without a whole lot of people around. And also at a time where you're able, both parties are able to focus with limited distractions. You can even do this on a private walk, for example, and really have a conversation. And I'll share with you some of the things you can say. People ask about, okay, get it, I need to talk to my friend or family member. But what do I say? Like, how do I actually have the words to say that I'm concerned? Right? And that's number two on my list. Number two, after finding the right time and place to talk to somebody that you would like to help is to express your concern and be direct about it. You see, in a lot of our cultures and communities, we don't speak very directly sometimes. I wonder how many of you feel this way and you're welcome to actually, actually at this point in the conversation, you're welcome to actually put questions in the chat box or use your emojis if you will to agree or disagree with what I'm saying. But I do think that sometimes we tend to talk in circles and not be very direct. Mental health requires people to be pretty direct whenever possible. But there's ways to do it, to be careful and really to also be very cognizant of someone's emotions and how they're doing. So here are a couple of ways to say this, right? To express your concern. Something like, I've been worried about you. Can we talk? Right? It's very direct. It expresses that you're worried and you have a clear request to talk to somebody. Right? You could also say, if you're not comfortable with me, then who would you be comfortable with? And maybe that person has somebody else in mind and maybe it's not quite you. And that's okay, because the point is that they actually get the help they need. Right? You could say something like, I see you're going through something. How can I best support you? Now notice in that particular statement, it's very carefully worded. There's no blame. There's no judgment. There isn't a sense of like, why are you staying on that couch? You're not getting out of your bed for so long. Why are you being so lazy? How come you're not getting anything done? You know, you're not finishing your job. Right? None of those sentiments. But you may be thinking those things are worried about those things, but simply you say, I see you're going through something. Right? How can I best support you? And it's very circumscribed what you're asking. That way, if there is something you can help with, they can actually say it. Right? If you don't like either one of those two, and you can always tailor custom tailor this to what's comfortable to you in your words. But you can also say something like, I care about you. Right? It's very clear and direct. I care about you and I'm here to listen. Do you want to talk about what's going on? Right? That's even more clear than what I said previously. And that's another way to say it. Or something like, I've noticed that you haven't seemed like yourself lately. How can I help? Right? And again, use your own rendition of this. Right? Put your own flavor to it. But the point is, it's you're expressing a concern, and you're being direct about it. Right? And I know there's people who are going to say, I know I welcome your questions and feedback in the chat box, who might say that will never fly with my family member, or maybe it's an elder in the family. I like that would never work. Right? You can definitely have your own way of saying this as well. And sometimes it's simply not you. Sometimes it's actually going to be that you're recruiting help from someone else that person will listen to. Like when it's an elder in the family, sometimes I say to my patients, who will that person listen to? Maybe it's someone who's at their age and level. Like their sibling. Right? Or their good friend who you can recruit and actually ask for help and say, Hey, I've been really worried about my uncle or aunt. Let's say, can you talk to them? Right? And so sometimes it's also being creative and how to get the person help that needs help. So to review, I shared number one and number two out of five so far. Number one was to identify an appropriate time and place. And number two was express concerns and to be direct. And then I shared some examples. Now, number three, when they do speak to you, number three is acknowledge their feelings and listen and listen. I'll say it again and listen. We go through training as psychiatrists and those who go through other mental health training, like clinicians, like therapists, we spent a lot of time in our trainings learning how to listen. And this is not always as easy for family and friends, because we have a level of familiarity already with the person. So we're kind of jumping to conclusions and sometimes cutting them off and sometimes not fully listening to what they exactly need. And that might be difficult for the person going through something. So when you listen openly and actively and without judgment, they actually may share things with you that you didn't even realize was happening. Sometimes parents are amazed that it's right under their own roof and they're like, how do I not know? Because there may not have been the space to really have that open conversation, or they're really worried about judgment. Now, that this doesn't mean that a family can't have rules and regulations in their home. But what I mean by judgment is, if someone is in a crisis or close to it, it actually in that moment, judgment doesn't have a place only getting them help does. And that's really important to understand. Number four, offer to help. Provide reassurance, let them understand that mental health is in fact, condition that one in five people are going to experience. When you think about what that means, you and I know more than five people. In fact, we may have more than five people in our own families, in our own, you know, nuclear family, let alone our extended families, let alone our friends and community circles. There is a lot more mental health conditions out there than you probably realize, and probably much more than are actually diagnosed. What that means is there are people who are going through a lot. And if the pandemic has taught us anything, it's that a lot of us are going through a lot. And so when we offer to help and say it by normalizing, by saying, this is something many of us are going through, let's try to figure out how to connect you to care, sometimes comes off as much more helpful actually, and reassuring that it's not just you, right? And number five, and the last of my list here is to be patient, to recognize that sometimes this kind of help with mental health in general does not go away overnight. It does not work this way. And many of the conditions that Dr. Roxana referred to are chronic. They actually come and go throughout a person's life. So they may never actually disappear, but they can have treatment, and they can get better. Even if there is not a full cure, like a person may have a chronic condition, they may be able to live a full and healthy and vibrant life with good treatment and good care by their doctors and physicians. And so I encourage you, inshallah, to take a look at these five steps and to see if you're able to implement them. And please be patient. Please know that mental health, like any other major health condition, doesn't just disappear overnight. So hopefully with our kind of listening and helping, we're able to do the bridging to care that I think a lot of us that are here actually want to do, inshallah. And so with that, I hope that was useful kind of five very concrete steps. And I'll turn it back over actually to Dr. Roxana to talk a little bit more about our duties. How do we address these stigmas? Okay. Thank you, Dr. Rania. So a lot of people will ask, why does stigma with mental illness exist? If someone had rheumatoid arthritis, for example, we would have empathy for that person. We would offer support. We would help connect that person to specialists that could get them in for treatment. And we would never think that they did anything to bring this upon themselves. We would never place blame on that person or shame that person for having rheumatoid arthritis, right? It even sort of sounds silly to say that. So why do we do this with mental illness? And with mental illness, what we find is that stigma is actually sort of a level of self-protection or denial in a way, if you'll kind of allow me this. So I think what I have seen is that when someone has mental illness, there may be part of us that may blame the person or there may be this sort of thought of, well, there's something defective in them, there's something wrong with them. They brought it on themselves. If they just prayed more or exercised more or ate better, they wouldn't be depressed. And it sounds so harsh to sort of think that someone may have those thoughts. But I think we hear that sometimes that if they would just do something a little bit better, they wouldn't be in this situation. So why do we have those thoughts? Why do we think that? And I think that we sometimes will have that line of thinking because in a way, it sort of is self-protection or denial that it could ever be us, that we could never be in that situation because we do X, Y, or Z. But just as Dr. Rania said, so many people have mental illness in one form or another, either you yourself or someone you know. And we know that if we look at depression, for example, one out of 10 Americans will experience depression. When we think about postpartum depression, it's about one in eight. And as an adult psychiatrist, I can tell you that I hear lots of things from my patients and I can assure you that all of the same illnesses and challenges that non-Muslims face in terms of their mental health, Muslims are experiencing it as well. And so it really is I think coming from a place of denial to think that we could never experience mental illness or that mental illness isn't part of our culture, our religion, or our experience. But what we come to find, though, is that of course Muslims are experiencing mental illness. And what can be so dangerous with that stigma associated with mental health is that stigma can kill. This, of course, happens when people don't seek care in a timely manner. But the good news is that more and more Muslims are seeking care for their mental health. And I've seen this even in my own practice over the last couple of years. But what I do see sometimes, though, is that when Muslims are seeking care, they're seeking care later in the course of their illness compared to non-Muslims. And this sort of feels similar to me, for example, when if a woman were to come in for breast cancer, but she's waiting until there's a mass that is practically extruding out of her chest wall, and sometimes it's physicians and you see a patient like this and you wonder, oh my gosh, why? Why did they wait so long to come in? And so of course, you can think about all of the many reasons that there may be, whether it was denial, maybe they didn't think it was that bad, maybe they were trying some treatments on their own, maybe they were just hoping it would go away. And if they had come in earlier, it would be so much easier to treat better prognosis. And so similarly with our mental health, it's so easy to postpone care. It's so easy to say, I don't only have time for this, it's too hard, I don't know who to really talk to. And we may not even recognize those signs of mental illness in ourselves. Maybe families might be in denial about what's going on. That person may be minimizing symptoms, you know, maybe they've tried some different treatments, maybe they've tried, you know, going to the mustard and talking to their imam about it. Maybe they've suffered in silence, sort of thinking that it's their burden to bear. And so then finally, when they do come in, we have a lot of catching up to do, we have a lot of educating the patient to do about their illness and how we go about treating it. So what I can tell you, though, is that as people are starting to feel better and they're starting to kind of like come back to life again, so many people will tell me, you know, Dr. Iqbal, I wish I had come in sooner. And I say, I'm glad you came in, I'm glad you're feeling better. So how can we help to eliminate that stigma? So, you know, there's really, I think, a few things that we can do to help eliminate stigma. I think really honestly, the first thing is just to acknowledge that it could really be any one of us. And it may be, you know, us, that mental illness can happen to anyone. The second thing really is education. And so conversations like this, in this space, and like on a community level, conversations in other spaces as well. For example, I've seen more and more imams, at least in the Chicagoland area where I'm from, use the Jimahutba as an opportunity to talk about mental health and to talk about practical things that people can do to help inject more love and affection and kindness and care, you know, in their day to day family lives. So that's been really refreshing to see. And Alhamdulillah, our local Masjid Mecca Center in the western suburbs of Chicago has really prioritized the mental health of our community, so much so that we were able to do a needs assessment and a survey to ask our community members, you know, what is stressing you out right now? What are your biggest mental health challenges that you're facing? And we've had a lot of support from our imams, the board, the community. And with that input, we've been able to directly take that feedback and start to plan programming for the next year, where we hope to be able to have lots of different programs surrounding mental health, different types of conversations, and got lots of ideas about how we can kind of implement that and connect with our community. And so I think as organizations, we can also help each other by sharing different initiatives that we're doing. So that way, we're not reinventing the wheel, but trying to kind of work more collaboratively. And so the last section that I'll talk about are what are potentially some of those silver linings of chronic mental illness. And you know, when I thought about this, I thought, you know, in a secular sense, it's really hard to see what would be the advantage of having mental illness. But if we kind of shift that a little bit and sort of think of it more in a spiritual context, we can see how those hardships can be a means of getting closer to Allah, you know, to strengthening that tawafal, that connection to him. And like Dr. Rania said, knowing that he has provided a cure for every illness and to not give up hope that, you know, inshallah, there will be a cure for mental illness. Right now, we've got lots of treatments that can help people get functioning better. And I think what's interesting is, you know, at the beginning of the pandemic, you know, obviously, a lot of people were having a tough time and were struggling. And so many people were seeking mental health care. But there were a good chunk of my patients who were doing okay. And I thought that was so interesting. And I asked them about it. And they said, Well, you know, we've been through really challenging things in our life before. But we've done the work, we know what triggers us, we know what coping strategies work for us. So, you know, going into the pandemic, they were armed with all of their coping strategies and all of their skills. And they had proven their resilience, and they already had that framework for coping with difficulty. And so, you know, what I think is just so remarkable is that Islam in, you know, in our faith tradition, we already have this amazing beautiful framework to cope with difficulty. And it's funny, because every time I hear of a new trendy coping strategy, Islam already has it. So the newest one that I saw, and I always have to laugh because it's just so, it's just so funny, is literally that cultivating a sense of awe was one that I came upon recently. And basically, that's just, you know, having that experience of seeing something and just saying, Subhanallah, right? And so, you know, Islam already has that. There's so many examples of this, whether it's, you know, finding moments of mindfulness when you're praying or reading Quran or reflecting. Maybe it's, you know, making an intention. We hear that so often. And, you know, we know that that's part of our tradition. The very act of just saying Alhamdulillah and good and bad, that's basically kind of the framework of positive psychology and emphasizing and highlighting the positive without dismissing the negative. You're acknowledging it, but you're also really paying attention to the positive and saying Alhamdulillah, you know, no matter what the situation is. So, you know, Alhamdulillah, Islam has given us so many tools and resources for our mental health. And I'm so grateful that Maristan is really helping us to be able to connect back to that. So with that, I'll turn that over to Dr. Rania. Thank you so much, Dr. Oksana. And yes, I mean, I, everything you said is so spot on. I think, right this point, really just adding a little bit here more related to how else can we help? And if you remember earlier, I was mentioning different categories of people, right? I was mentioning family members, friends, teachers, people who are leaders, whether you be religious leaders or community leaders or youth leaders or Sunday school teachers, people who help in all different capacities within our communities, everybody has a role. And I think that's probably the strongest message I can give everything that Dr. Oksana shared in terms of how tos, right? Now comes our duties in terms of all of these different categories I mentioned, because many of us actually fit in to multiple categories. And the first thing I want to share is our responsibility, our responsibility related to mental health, whether again, you be that parent or the teacher or professional or a friend or a leader, we all actually carry responsibilities. I have trained a number of Imams and religious leaders on mental health. And it's always surprising to me when I come to the section of my training that says, as leaders, you are somebody who is a mandated reporter, for example. But if somebody comes to you in the context of let's use here, and I'll give my trigger warning of a difficult topic on suicide, that someone says something about their life isn't worth living or they may end it. And they're going to a religious leader or they're going to any community leader for that matter. Maybe it's their youth group leader and saying that there is a responsibility, not just from the religion, which I'll come to in a moment, because that applies to all of us. But there's also rules and regulations and laws of our land that govern these things. And if a person isn't a place of leadership, they actually have to intervene and help. It's not a choice. And so I'm always surprised and a little bit amazed. And I'm glad we do these trainings in order to make sure that people know. And I saw a comment in the chat box related to wasn't about suicide, but rather it sounded like maybe it was related to postpartum depression. I can't tell you how many communities I've gone to where we're talking about various mental health conditions and postpartum depression being one of them. Of course, the numbers there are one in four. And I'll say what I said before, all of everybody here knows more than four women who have been pregnant in their life and have had children. It is a very common condition. And is this one in particular is very much biological and hormonally driven. It's not anyone's fault. And yet I have what you said in the chat box, they're the person who wrote that I agree with you. There have been many people in communities that have tried to approach leadership, particularly religious leader, but even other forms of leaders or community members, people who are in charge of things and say, I'm going through a rough time. And just sort of get sidestepped or brushed aside. And this is not acceptable whatsoever. A lot of times this happens because of lack of knowledge. Certainly, people don't know how to react. But something Dr. Roxana said is very important. The end result of some of these conditions could be fatal. Not all mental health conditions are fatal, of course. But certainly, if a person reaches a point of the brink of despair, because of their clinical depression, because of the postpartum depression, because of really any of their conditions, that is very problematic and actually quite terrifying, I might add. And to carry that with you is very heavy. Please know that there are actually rules related to this and intervention. I'll share quickly, since I mentioned the topic of suicide and say that our lab at the Stanford Muslim Health and Islamic Psychology Lab, we spent the last several years. It's about a cost of five years developing an entire manual on suicide response, prevention, intervention, and postvention. Postvention is what you do in a crisis mode in the aftermath of the unfortunate case of a suicide. Custom tailored for Muslim communities. And now we have these trainings that Madison offers their whole day certification trainings for leadership to be anybody who's on the front lines, your Sunday school teachers, your Islamic school teachers, if you are somebody who might be in the front lines of the Muslim community and people come to you, you see and interact with Muslims, whether they be kids or adults, especially our imams and religious leaders, but all their forms too of community leaders and members. And I'm always amazed too of how little education has reached our communities because of the stigma around mental health. So the first and foremost thing is the openness of being willing to have these conversations, like Dr. Oksana, I'm heartened that we have as many people attending this webinar as we have today. And I'm heartened by how many people are willing and understand after the pandemic how crucial this is. And I'm also raising the red flag a little bit and saying that if we don't have these conversations, if we don't have the resources, if we don't bridge people to care, right, we will see fatalities. The research already has said that we've published that paper already and it's caused some interest and also some alarm in the community. But that's what the data shows that Muslims do have a high level of suicide attempts here in America. Why is that? Well, there's a lot to people ask why is that there's a lot that comes with that. And having the difficulties we as a general Muslim community have faced over the last many years is definitely part and parcel of the story. But so is the fact that our community doesn't tend to always be bridged to care or willing to very immediately get the care. And so like Dr. Oksana said, sometimes it's a little too late by the time it actually comes to pass. So I'm so glad that we're having these conversations. And I also think that now to switch a little bit to the more spiritual and religious part of the conversation, since we're all, of course, here together gathered because we're talking about Muslims and faith, there is amazing amounts of resiliency within our Dean. And like Dr. Oksana said, so many of the treatment protocols that are out there are types of therapy, the essence of which you can find within our faith and religion subhan Allah. Even even the topic of suicide currently we're writing a study that actually is called Islam based resiliency to suicide using character and moral traits within the faith to prevent against suicide. So and that is something that is highly effective if we're able to channel in the right direction. Now, what I mean by that is not just that it's a spiritual treatment for mental health, but that it's a holistic treatment that you talk about biology and genetics and medications and therapy, but you're also talking about someone's spiritual state and how they're doing for many people of faith, they find a source of comfort and relief within their faith, within their prayers, within that connectedness of their community. And that is part and parcel of it and it's lacking in a lot of our secular systems. And so, you know, I say all of this because it comes back down to responsibility. From the religious and faith point of view, we have all of us, whether you're a leader or not, whether you're somebody in a position of power or not, whether you're able to make a difference or not, but I would actually hazard to say you can and will make a difference. Our Dean puts that onus on us. The Prophet ﷺ was asked by his companions who said, shall we seek out treatments when we're ill? As in to say, the hidden question in that question is what? Is it enough to just pray? Is it enough to just make dua? Is it enough to just tell the person, have some patience, have stronger iman or faith? That's the hidden question within the question. And the Prophet ﷺ responded and said in a Sahih tradition, right, a Sahih hadith, he said, O servants of Allah. So that means all of us, all people who are believers. O servants of Allah, seek out treatment. Dada will seek out treatments. And then he continues it and says, for every illness that Allah sends to earth, that Allah sends down, he sends with it its cure. And in a different narration, it says, it's treatment. So either dua or shifa, right? This is highly important because it is the very thing that pushed our noble predecessors, right, the early Muslims, scholars who understood and looked at these hadith and looked at this and were inspired to get care to build institutions like the matastas, like our namesake, right, that incorporated mental health. They were the first human history to have mental health within their hospitals. That's no accident that the Muslims were first. It's because of this religious injunction or understanding. And so when we find Muslims today, modern Muslims who A, don't realize that or B, are very willing to prescribe just prayer and iman, stronger faith and kind of sidestep completely that there are treatments that God allowed humans to create and find from the illnesses that he also sent down, right? This is problematic in many, many levels. And so I hope that this is encouraging to all of us. If people wanted the religious proofs, they're there. If they wanted the proof from the early noble predecessors, they are there, right? If they wanted the proof and the pudding of our institutions, well, here's my backdrop of the matastas, right? This particular one was from Damascus. They were there everywhere Islam went, just like it had massages and for prayers, just like it had madrasas for learning. They were matastas for healing. Everywhere Islam went, you found those institutions everywhere Islam went, even up into the parts of Europe that Islam entered. The reason I say all of this, you know, for all those who are attending is that it's really important to know that we all have a duty. We all play a duty. Some of us play multiple duties because we're also teachers or also leaders. And so we have extra duties and mandated reporting and mandated trainings that we really need to undertake. But some of us are only in one or two of those categories, we may be a parent and a friend, right? Or a loved one and a sibling, right? Regardless, we all have these duties to play. And so I hope that this helps us kind of understand our roles in all of this and the steps that I outlined earlier, the five steps helps us really take and have the courage to take those next steps. And at this point in the conversation, I really hope, inshallah, that we can help answer your questions because I see many of your questions in the chat box to the Q&A box. And I know some of you have questions you'd like to ask us directly. And so at this point, I'm going to invite Dr. Aksana back to the stage with me. And we would love to just have you ask us your questions and help us help answer some of the questions you have that are more specific to what we've presented here. I do hope this has been useful. Insha'Allah. Jazakallah. Thank you so much, Dr. Dania. Dr. Aksana, this was very informative. Alhamdulillah. And as you can see in the chat, a lot of people are commenting on how helpful this has been. So I'm going to go ahead and share a few questions and then whoever feels comfortable answering, just feel free to jump on. So we have a question about how do you differentiate between basically mental illness and gen possessions? I can start, inshallah. This is a very common question that comes up. And I appreciate the question very much. It's a question that comes up because within our Dean, and I'm going to preface by saying this, within our Dean, Allah Subh'anaHu Wa Ta-A'la talks about the supernatural creations. So we know that Allah Subh'anaHu Wa Ta-A'la created humans, but He also created entities that we cannot see but we believe in, like the angels and also like the Jinn. And this question about can the Jinn possess somebody? Can the Jinn cause a person to experience some sort of psychotic condition or mental health condition? And my answer to this usually when people ask me as a psychiatrist is, look, I'm not going to deny that these are creations of Allah Subh'anaHu Wa Ta-A'la, but I'm also not trained in being able to extract a Jinn, for example, from a person if they're there. There are certain Shiyyuch and Imams who have trained in this. And there are others who have the ability to do Ruqya or to have Qur'an read upon a person or simply like the Prophet Sallallahu alayhi wa sallam did to read Qur'an upon yourself for protection. And so what I say to my patients is, I have no problem with you taking on this Sunnah of the Prophet Sallallahu alayhi wa sallam of Ruqya if it helps you. That's now distinguished, though, that if that was limited, because sometimes people say that's all I want, I just want the Qur'an, I don't want anything else. And so what I'll say is, if that helps you, and this issue goes away, Alhamdulillah, but can we come to an agreement that if it is not sufficient as in to say the symptoms are still there, that we agree that you will continue with the Qur'an and the Ruqya, but that you will also seek out psychiatric care for your condition. I can't tell you just by looking at you, which exactly is happening. But what I can tell you is if it is in fact psychosis, which is a serious mental health condition, we definitely have the medications and the treatment to help it so much so that you may be able to live a fruitful life without having active psychosis constantly that you're battling with. And so that is the agreement that I tend to come with with my patients. And I have on my phone, you're in the local community in which I live, you know, some of the Imams that we have a good relationship with, in which are able to say, and this is what I mean by a good relationship, they will do that Ruqya or they will kind of, you know, assess a person to see if this is actually true or not. But when they feel that they have reached their limit or they can't help, or this is not a spiritual supernatural issue, but rather a mental health psychosis issue, they will say, you need to go see the doctors, go back to the doctor on your other doctors. And I appreciate that very much, because now we have a what a two-way road of communication. If a person wants that spiritual religious help, they can get it. But if that spiritual leader doesn't bite off more, they can chew. If they cannot help, they refer back to the doctors. And not every community has that I realize, but we need to get there more and more. That would be the ideal, right? Because I don't think that it's okay to just brush off a person's concern that this may be Jinn or maybe what wasn't asked here is like Sihr or black magic or Ain, the evil eye, all of which are mentioned by Allah Subh'anaHu Wa Ta-A'la and are part of our tradition. But Muslims tend to do this thing where we chalk up everything to those things. And the reality is many times, many times, many times they're not related to those things. Thank you so much, Dr. Donnie. There's another question in the chat that says, what do you do with older individuals who are not used to sharing their emotions and feelings? How do you help them articulate their feelings when it's not, they don't have the words to do so? Do you want to take a jab at it, Dr. Oksana? Sure, sure. And that's a great question. I think, especially over the pandemic, a lot of our older patients have struggled, especially in the beginning when we were so isolated and people weren't able to see their loved ones, their children and their grandchildren. And so I think in situations like that, trying to find some sort of inroad, whether it's a person that they have a good relationship with that perhaps could talk with them or if there's something that they like to do, sometimes it's easier. Dr. Donnie had mentioned sort of having that conversation on a walk. Sometimes just getting up and having some movement can kind of allow for a more free flowing conversation. So whether it's when you're maybe going for a walk or maybe going for a drive, sometimes just being in that kind of contained place might be a place where you can kind of have a more sort of intimate conversation with that person. And I wasn't sure from the question if that person was referring to perhaps if there was memory issues impacting that person's ability to communicate or if there were other factors making it difficult for that person to communicate. Of course, if that's at play, then you're getting that person in usually to their primary care doctor is a great first place to start because in situations like that, you always just want to make sure that there's nothing medically going on with that person that could be impacting their current situation. So we have another question about maybe symptoms that are not so obvious. So as an adult, what are some things to look for in terms of mental illnesses that might emerge in adulthood or might not have obvious signs? Like she says she has a friend who is 34 and he just found out he has autism. But she's wondering as adults, how do you find those like more subtle signs to go and get tested essentially? Dr. Oksana or Dr. Dania who wants to take this one. Do you like to Dr. Oksana? I can start. I think what's interesting is that so many of the childhood disorders that we see, they don't always go away as you become an adult and so they do linger and may look different as an adult. And so sometimes it's not until you're an adult and perhaps you have your own children and they're being evaluated for something like autism spectrum or ADHD. I see that a lot. And then as that adult is starting to learn about what those symptoms are, they start to see some of those symptoms within themselves. And then they wonder, well, could I have autism or could I have ADHD? And I think that's really where you're trying to get in with a psychiatrist or someone that can make that evaluation. Because it's obviously easy to read something online and to think, oh, I think I have this. And, you know, it takes a more nuanced look at the whole entire picture because there can be so many things going on in that person's life that may lead that person to think that they may have autism spectrum. You know, maybe they're sort of identifying with some of the sensory processing difficulties or maybe they're identifying with some of the difficulties in social interactions and the sort of, you know, overwhelming shyness that some people will have or difficulties with, you know, change in routines. And so I think that's where it's really helpful to make sure that you're seeking that care out by an expert who can make those diagnoses. Thank you so much. Dr. Dunn, I think this is a good question for you. How do you set healthy boundaries with someone suffering from mental health issues, especially when they have a history of not respecting your boundaries? Sure. Happy to answer that. And before I answer that, I'll just really quickly, I'm going to just quickly put this in the chat box for the previous question that just is about what happens if a person later in life kind of wonders if there were some symptoms of something they're dealing with that were kind of not caught in early adulthood and certainly now this concept of neurodiversity, which not everybody is neurotypical as the other word that we might use, but this diversity meaning like that there's something that you're dealing with. And it's this kind of different forms of brain, basically, we all have different brains of how they function. And so, you know, one that I see in my patients very commonly is like ADHD. It's often, especially women, is often missed quite a bit because unlike boys, little girls tend to not necessarily not this is not all the time, but most more often than boys will not be hyperactive. They won't be the ones bouncing off walls, but they will might be kind of and so they're missed by their teachers. And so what they're doing with their ADHD and how it manifests as young girls is they may actually be losing concentration in class by daydreaming or kind of like thinking about something totally different, right? And like, and it affects their grades and affects their work. But they're not reported to the principal's office or whatever, because they're not bouncing off walls like a boy might. And then if you think about if you go through life like that over time, they go through elementary, middle, high school into college, and it may be years and years until this is actually, it might be like, I wonder if I have ADHD, I can never seem to finish my tasks. I can never seem to concentrate. I keep jumping from thing to thing. And, and, and often enough, I have to say this too. Unfortunately, because of that people get labeled and they get told things like you're not smart enough, you're not intelligent enough, you are these kind of very negative things. And they tie that their own self-esteem and their intelligence with something like lack of concentration, which is actually easily fixed by treatment and medication. And they start to believe that they're not intelligent. And then once they're told, there is actually no connection between intelligence and ADHD. There's no connection between them. And so they're like, what? And it's just so that's, and I've had so many patients just break down crying in my office because they have come to now understand that they're not unintelligent. They actually have a condition that's treatable but was missed early on. And so this is where I very much agree with Dr. Oksana about, you know, getting the help, there's no, you're never too young to, right? Reach out for help. And it's an assessment. And if you don't have it, you don't have it, right? And if you do, there's probably a treatment for it. So before, sorry, I went to the next question. I just wanted to share that. The link I put here is a free summit that Stanford hosts every year on neurodiversity, everything from autism spectrum to things like ADHD and whatnot. And it's just a helpful, you know, informational session. There's many like it, I'm sure, and other institutions too. This is one I'm familiar with. Back to your other questions. And well, really quickly, I think it was about boundaries and what to do if a person that has a mental health condition, but isn't respecting other people's boundaries. I think that was the question, right? Yeah, this is also a little bit, you know, not, not the easiest thing to navigate because you want to be, of course, supportive to that person and helpful to that person. But it may vary will be that their condition, and this is where I remind you, remember that last step number five in the list was about patients? I remind you that sometimes these are manifestations of the illness themselves. So the person who is not well, doing well, they may not even rationally realize that they're, you know, kind of crossing these boundaries, even if you are attempting to tell them. And so you try, and you try again, and you try your best. And if your self wellness, like if your wellness and well-being is being altered by this, you know, is affected by this, then it may require that there is some distancing and having somebody else try to be the person who is more in contact with them. If there's somebody who they really depends, it's a very case by case question. There's no real one fits all answer here. One size fits all. But if there's somebody who listens to you and is willing to take some direction from you and you say to them, and you can ask them things like, are you connected to your therapist? Are you connected to someone who can help more and listen to these, you know, and then if you're a family member or kind of somebody who's connected as a loved one, a family member, you may very well ask, and I told people to do this, to ask permission to be in the next counseling session, like a sibling or a parent or a friend, not so much a friend, but more like somebody who's a family member, a spouse, and to actually say, look, this is, and if they get permission to be in that counseling session, so that the counselor could at least understand what's happening. And then the counselor, the therapist can set help set the boundaries, right, for the person that they're treating. And that sometimes is pretty effective as well. So it just really depends, of course, this is a very open question. It wasn't specific to a certain case, but I hope some of what I said is useful. And Shalma. Shalma, thank you, Dr. Dania. Dr. Oksana, I'm going to have this question for you, because I know you work a lot with postpartum patients as well. Is it ever too late to seek therapy after having postpartum depression, but it's seven years later, and they feel better? So is seeking professional help still helpful, even though there are, I guess, over the postpartum depression? Sure. Now, that's a great question. I think in general, it depends. It's probably the answer to all of our questions here is that it oftentimes depends on the specific situation. But in general, what we, I think, can say is that, ideally, if you're still seeing difficulties with some aspect of functioning, I mean, usually that's sort of our threshold, right, is if there's some difficulty with functioning that mood or depression is impacting your ability to function, then yes, of course, you should definitely see a therapist or a psychiatrist. And in this situation where, if that postpartum depression was seven years ago, and you had a difficult time with it, but you made your way through and you're doing okay, it really kind of depends, again, on how that person is functioning. I guess what I would say, though, is if that person was planning to have children in the future, that would be a good opportunity to talk with your doctors about what you experienced in the past, and to really take a very proactive and preventative approach to how you might handle pregnancy, as well as postpartum, because what we know is that 50% of postpartum depression starts during pregnancy. So waiting until the baby is out is sometimes really too late. It's so much better to make sure that that person is taking care of themselves during pregnancy, that they're eating well, and they're exercising, and they're keeping in touch with family and friends, and doing all of those things that are building their support network that will help set them up to be successful in a postpartum. Thank you, Dr. Oksana. I'm combining two questions into one, Dr. Dania, for you. But basically, what should a person do if they're suffering from suicide ideation? And basically, what should we do also as a group to lower these numbers of suicide attempts, suicide ideation? So maybe we can answer those together. Sure thing. Yeah, I appreciate the question very much. What can we do, first of all? Absolutely, I think it's important that we don't brush this under the rug, whether it's our own family, our own house's rug, or whether it's our message rug, honestly, having these conversations, and this is, by the way, the number one tool for prevention of suicide is education. Education, education, education. The more you talk about this, the more you understand the signs, the more you know how to intervene, the more we will prevent these issues. I am, until I can back this by research, I don't want to say I'm 100% sure, but I have to say I'm fairly sure that some of the numbers that are elevated have to do with the lack of education and openness around these topics in our communities. And so what does that mean? It means that just as our imams have been, like Dr. Oksana was saying in her community, they've been willing to talk about mental health right from the nimba, right from the pulpit, right in the khutbas, right? I want to tell you that on Madison's website, if you go there, there is a section on suicide response, and you'll find multiple things there, one of which is actually free downloadable khutbas that you can literally hand your imam and say, here is a khutba that you can read. And September is Suicide Awareness Month, for example, maybe that month or maybe some other time of the year planned, right? And it might be kind of a little bit strange at first for communities, but people will get used to it just like they have by and by and large, we've all gotten more used to talking about mental health than we were 10 or 20 years ago, right? Same will happen with this topic too. Families and friends and those who are in leadership can definitely get our training at Madison. And so look out for them, be on our mailing list, and definitely look out for when the trainings are being offered. Sometimes there are short workshops, and sometimes there are the full-on certification training, and you can take both if you wish. Sanwa, I'm going to just ask you for a follow-up on your other question. There was a combined question. What was the other one? So it's about basically how to decrease these numbers in general, but if a person themselves is suffering from suicide ideation, what should they do? Yes. Yes. Thank you. This is one of those conditions that a person or a loved one who hears about this, a friend or loved one, this is not one that you can wait out. This is not one where you can say, oh, it'll get better over time or get better tomorrow. This is one that we consider to be a psychiatric crisis or emergency. Now, I have found a lot of times, in fact, I was just dealing, I was on call this weekend and I was dealing with it all weekend, between our Stanford students, between people at the hospital, between people in the community, and it happens so often where people say, I'm fine, I'm okay, I don't need help. But if they have been dropping hints that there is actually, that life isn't worth living or they can't see that light at the end of the tunnel anymore, this is considered to be an emergency. And an emergency means you need to go to a mental health professional. Please know that at hospitals, in their emergency department, there is a psychiatrist that is on call, or they can get access to one who is on call 24 hours in a day. Why is that important? It means there is always help available. You can take yourself or you can take a loved one there. And they let them do the assessment for them to decide whether or not you need extra help and support, or whether you simply need to be connected to a counselor and therapist, or whether you are going to be fine tomorrow, right? You don't make that call yourself. And if you're a family member or friend, don't make that call yourself. You, with all due respect, haven't gone through the years and years of training, we professionals have gone through to be able to assess and make that choice, decision on what is happening with the person at hand. Why am I being very strong about this? It's kind of like I'm kind of hammering down this point. We've just seen too many tragedies, folks. We've seen too many tragedies. Just last weekend, there was another big headliner that came out of the Houston Muslim community, right? I mean, there's just always things that are happening. And those of us who are in the field see this a lot more, right, than what happens on the news. And that's why I'm being really strict about this. And so I really encourage you to know that there is help available. And to also know that there are signs that you can know. Also on our Madison website on that same tab that's called Muslim Suicide Response, there are links to a couple of articles that we've written with folks in my lab, things like the top 10 signs of suicide response. Another article that talks about what to do in the aftermath of a suicide and so on and so forth. Maybe we can actually put some of those links right here in the chat box for you. But we've produced a lot of material and resources around this topic. And I really hope you can benefit from it, inshallah. And by you knowing and educating and advocating that these conversations make it to your community centers, then inshallah, we can start preventing more and more of this. Inshallah. I'm Jazak Al-Khayran. I have a really direct question. It should be quick to answer. How do you find a psychologist online who accepts health insurance? Yeah, Dr. Excetti, you're welcome too. Sure. I was going to say that sometimes the simplest place to maybe start would just be even something like the Psychology Today website is a good place to start because you can input different factors that you're looking for in terms of insurances that this person accepts and location and even sometimes languages that are spoken. Sometimes, especially if you're in an area where you don't know of any maybe Muslim therapist or psychiatrist offhand, then that may be a good place to start. And so I would kind of start there. Thank you so much, Dr. Exana. Dr. Don, I'm going to combine a question for you related to medication. So part one, a lot of people have fear of medication. So how do you have parents overcome this fear, especially if it's treating their children? And then part two, which is related, what do you do about severe side effects of psychiatric medications? Yeah, wonderful question as well. And I think it's important to know that it's a very real concern about medications and side effects. What I usually tell people is what about the alternatives? Are there good alternatives that have been researched in which there is good backing that a person is always going to is going to get better? And this is where I say it really depends on even mental illness and their each condition itself is on a spectrum, as in to say it could be anything from mild to moderate to severe to extreme. And it depends and this is where your mental health professional becomes really important because they're trained to figure out where in that spectrum are you in terms of your depression, your anxiety, or your ADHD, or your OCD, or your phobias, whatever it may be, there's so many different conditions out there. And depending on that, the answer would be sometimes you don't need medications. And depending on if it's more severe, you may very well need medications. Ultimately, you will be the one to decide if you're going to take them or not. And this is what I say to people on certain conditions. I gave the example just the other day I was talking about OCD, obsessive compulsive disorder, which I do a lot of work around and work with. And one of the things that it's actually graded just like this mild, moderate, severe, and extreme, and there's actually measures that you are given by your doctor to figure out where in that spectrum are you. And what we know is that something that's like mild usually can be handled by therapy alone, usually. But when it becomes something that's more moderate or moderate to severe or even extreme, at this point is where there is so much research behind why the medications are important. Take something like OCD. If I put you under an MRI machine, an fMRI machine, a person's brain that has OCD will actually light up. There is a deficiency there. There is something there that requires the medication to help it. And what I find with my patients, and I'll tell them, look, the gold standard is a combination between medications and therapy. And a certain kind of therapy. It's specifically called ERP or Exposure Ritual Revention Therapy. I'm saying all of this to explain to you that when my patients say the same thing, I don't want this medication. I'm worried about side effects. I say, well, what is our alternative? I don't have for you a natural based alternative that would absolutely make this go away. What I do know is the medication that I do have to offer you, you will see for yourself and you can judge for yourself and you can come right back off of it if you don't like it. But what ends up happening is a person, most of my Muslim patients will start off with just therapy. I'm like, all right, let's start with therapy. And they'll work really, really, really hard at therapy. But some of these conditions, depending again, if they're moderate to severe, they require that medication. And so they themselves will later come several weeks into the therapy and say, Dr. Ania, can I have some medications for this? Like on their own, because it's just so heavy. And once they take the medications and we get through those stages and side effects and what works and what doesn't, and we kind of, you know, have to tinker a little bit, eventually they get to a point and go, whoa, why didn't I do this way before? It's almost always, and I see Dr. Xana nodding. It's almost always the same story over and over again. And so because it's like a night and day difference, a night and day difference sometimes, and all those things that have been holding back and spending hours and hours of their brain space and time in this condition they have suddenly falls away with the medication. And then we use the therapy for the more heavier things that require extra behavioral changes, right? And together, their life completely turns around, they go from being almost non-functional to being there and have so many stories upon a lot, not just functional, finishing their jobs, getting their masters, getting their careers, getting jobs, having children, you know, like just so many things upon a lot that they were totally limited from being able to do. The reason I say this to you is certain conditions require a medication, and there's just no two ways around it. And it's not against our sonan to take it either. And in terms of side effects, I remind us that all medications have side effects, including the Tylenol you take for headaches sometimes. And everyone has different set of side effects. And if your doctor is a good one, they will work with you to figure out which is the medication that has the least side effects at the least dose that is effective for you. And so if you have a serious or moderately serious condition, again, the question is what is the alternative? If it's affecting your life so much that you cannot go forward and what's holding you back is a fear of side effects, but you haven't even tried yet to see if the side effects, they want to affect you or at that dose, it's not so bad or you can live with the one side effect, but the rest of your life is very much improved. I encourage you to not let that fear stop you from getting the kind of care you where your loved one needs. Thank you so much, Dr. Dania. Dr. Oksana, I'm going to couple three questions together for you because they're around the same theme. But basically, what do you do when you know someone is depressed or they're going through some psychiatric issue? But they're in denial, they don't want to seek help, especially if it's your child and they're above age 18, so that you can't really force treatment upon them. Or sometimes in situations, somebody who is a lot older than you and you just can't get to them. So what's the solution when people don't want to be helped and they're in denial? Good question. I think I hear this a lot when people are struggling with a close family member that is experiencing something like depression or even something more severe like psychosis. And when they're over 18, you can't legally force them, but you can still have some influence over them. And I think like Dr. Dania had said earlier, there's so many ways of starting that conversation with that person. And I find that if you really start from a place of care and concern and you let them know that you've noticed that they haven't been eating dinner with the family anymore or they haven't been enjoying spending time with the grandkids anymore, and that you're concerned about how their mental health might be or how they're feeling and you'd like to be able to help them. And so I think by trying to have those conversations with those loved ones, that can be a place to start. Obviously, if there's any safety concerns, again, if they're talking about harming themselves or harming someone else, then that's when it kind of rises to that threshold of where you could potentially get police enforcement, et cetera, involved. So I recognize that it is a very difficult position to be in as a family member, but I would say try to use whatever influence you can. Insha'Allah. Thank you so much. And I guess this will be our final question. It's a personal advice, but this is somebody who's recently gotten through a loss of their mother and a divorce at the same time. So a lot of life situations. And during this situation, siblings are accusing this person of having mental issues because they're having more boundaries. And how do they know for certain that they have mental health issues or that they're just surrounded by toxicity or situational, or the situation is just making it seem that way. Do you want to try Dr. Dania for this one? I could try to take some part of it. So you're saying that if you can just repeat this part again? Yeah, so it's somebody who has gone through the loss of their mother and a divorce at the same time. So two life situations. And they've put more boundaries around their family and they become more firm and vocal with their boundaries. And because of that, their siblings are accusing them of having mental health issues and that she needs help or he needs help. So how do they know for certain that they have mental health issues? Or if it's just the siblings are just being toxic? There are two, there are two interplaying things happening here, probably maybe even more than two, but I'll mention two Insha'Allah. And first, before even I mentioned the two, I just want to say to the person who wrote this, thank you for being brave and actually even writing this and really asking yourself the question, is it me or is it them? I think that takes a lot of courage and really insight to try to figure that out. So I applaud you for that. Second, I want to say that if a person, any one of us has gone through what you've gone through and multiple things happening, even just one thing, let alone multiple difficulties in their life, it is very normal that a person may very well be handling heavy stressors. And sometimes it's not until you're finally in a safe place, like in the safe, confidential room of a therapist, let's say, and you actually start saying what you've been carrying, the load you've been carrying, that you realize how much you've actually been carrying. And that's something that's happened very commonly to folks I've worked with and even myself, you don't even realize how much you're carrying until you start speaking. And so I don't know that I would necessarily, and I can't obviously through this computer, you know, through virtual say, oh, you have a mental condition or you do not, I can't say that to you. But what I can say is it definitely sounds like you're carrying a lot and therapy very well could be useful. The second part of the question about the siblings or just whoever it is that's kind of saying, you know, that's just all mental health versus could it just be that you're setting your boundaries and you are in a different mind space and a different, you're operating in a different way than they're used to. So they don't know what to call this. So basically, they're saying, Oh, it must be your mental health. When in reality, it's just that it's very, very normal actually that when a person does start putting their boundaries in place, that people start accusing them of, you know, being this or that. And it's really just takes time to have somebody kind of accustomed to the new boundaries you've set. And you might just have to be a little bit patient with them, especially if they're like a sibling who's not understanding what is this, but what are these boundaries you've set? We don't have boundaries in our family, right? A lot of families do not have boundaries or good boundaries. And so when boundaries start being set, it feels very strange to people. Yeah, boundaries is something. And I say this to people all the time. This is not some weird Western world word that people that's like a like a like a bad word, people treat it like a bad word. Oh, those Westerners that talk about like boundaries, we don't have that in our culture. Allah subhanahu wa ta'ala talks about in the Quran, that he himself has set his own boundaries. This concept is not foreign to our Dean. And the importance of you being able to function at a space in a place that is actually healthy. Now, our Dean does not propagate cutting off ties with people, right? But it does tell us to make sure that we have the kind of boundaries, right? That allows us to help operate in health. And so if this all sounds either confusing to anyone who's listening to this, or you feel like, I wonder if this is happening to me, I feel like I need a little more help with this. This is actually a place that therapy could be very useful for, right? And again, this is where my bias is to have somebody, even if they're not Muslim, that is very much culturally and religiously trained, and has a background in congruent care to be able to say and understand and respect your traditions, right? And your culture and your Dean specifically, to be able to not just sort of throw out the baby with the bath water and say, Oh, cut them all off. They're all being terrible to you. Or this word toxic that I hear often people will say without really fully understanding it, or the other extreme of like, no, no, just, you should be there for people and people are literally stepping and walking all over you. And that's not from our Dean either, right? But that healthy middle way, which is from our Dean, sometimes you just need a little bit more guidance around it. And that's where I find, especially if somebody at least, if they're not Muslim, that they're at least culturally and religiously congruent in their care. But especially if there's somebody who's coming from the same tradition and background, that may be already built into the kind of therapy and care they're giving you. And so earlier in the chat box, we put in a link, many people are asking, how do I find these Muslim therapists? If you go to maristand.org backslash resources. It's we don't we don't vouch for these folks. All we did is we kind of put a list of directories of Muslim mental health providers across the US, Canada and international that we could find. And we're happy to put more directories if there's any on there that you know of that we don't know of yet. And you're welcome to click on those links and put in where you're located and find a Muslim mental health professional. You will need to be the one to reach out to them and see if they're a good fit for you. But at least it's a resource to get started somewhere, inshallah. I hope that was useful. Inshallah. Thank you so much, Dr. Dhania, Dr. Oksana. Hamza, I think we got through most of the questions or a few that we didn't. And I apologize. It just we do need to wrap up time. We do really care about your feedback. We usually have these learning circles about once a month. And your feed, the reason why we chose this topic today actually was because it was suggested in these feedback forms. So we would love it. If you can just scan the QR code here or in the chat, we will also have a link. It's literally like a two minute two minute feedback form. Just to let us know, did we meet your expectations? Are there other topics you're looking for? We want to hear from you, inshallah. So please do scan the QR code and then you can also go ahead and click on it in the chat. We also have provided for you a list of resources other than our website specific to this topic of chronic psychiatric disorders. Those will also be shared in the chat. Some of them are more Muslim based and some of them are more general. They're both very useful if you're looking for any source of resources, inshallah. In addition, if you enjoyed today, please consider contributing for future programings like this by scanning this code or going to the link in the chat. And as we mentioned earlier, it's been less than a month since Ramadan. And we've opened our doors for Madison's clinic. So if you are in the state of California, you can book an appointment by just scanning this code or I'm visiting the link in the chat. Now I know that this was a very popular question. Where can we seek Muslim therapists? And as we mentioned it before, you can go to madistan.org slash resources, where we do have a list of Muslim therapists from across the US and Canada. And as Dr. Donia mentioned, if you know of more, we will add them to the website. Do follow us. You can follow Dr. Donia, follow Madison, follow the Stanford Muslim Mental Health Insomics Psychology Lab. There were some questions about how do I find out about trainings? How do I find about future programings? This is how you can follow us. You can sign up for our email listserv. And inshallah, we really appreciate you being here today. The fact that you're here and you care about mental health says a lot. And inshallah, we will end with a short du'a with Dr. Donia. Thank you so much, Sanuan. Thank you so much for everybody who's been here and Dr. Roksana, especially. We really appreciate your super insightful knowledge. Inshallah, I'm going to just take two minutes to do a closing du'a. And we hope, inshallah, that you will help us with your any feedback that you might have for us, inshallah. And I do hope I'll see you kind of every month really from here on out. Please tell family and friends, please, about these programs. They are free. They're open. They're for everybody. And we do hope that folks can find use in them, inshallah. All right. With that, inshallah, we'll focus on our du'as. In the name of Allah, the Most Gracious, the Most Merciful. We pray to Allah, the Master of Muhammad, and to his family, and to his friends and companions. Allahumma, O Lord of the worlds, I ask You, O Lord, that You may forgive us, forgive us, and forgive us. You are our Lord. So, we pray to the disbelievers. O Allah, we ask You, O Kareem, to show us Your mercy upon us and to bless us and to increase us. Ya Rabbi, all that is good. We ask Ya Rabbi Al-Alamin to make us from those who are connected to You and accepted by You and those Ya Rabbi who are beloved to You. Ya Kareem, we ask You for health and shifa for all those who are in attendance and all of their family and friends and loved ones and children. Ya Rabbi Al-Alamin, we ask You to make us from those who are able, Ya Kareem, to take the knowledge that we have learned and implemented in our lives. Ya Rabbi, help us implement the knowledge we have learned to make it. Ya Rabbi, our lives and those who are connected to us, more easy, Ya Kareem, and more fruitful. And, Ya Rabbi, full of healing, Ya Kareem. Ya Allah, we ask Ya Rabbi Al-Alamin to accept us and to make us from those, Ya Rabbi, who are granted Jannah. And from those, Ya Rabbi Al-Alamin, from those who are able to reach the highest levels of Jannah, and the Shuhada, and the Anbiya, and the Prophet Muhammad, Sallallahu Alaihi Wasallam. Ya Rabbi, bless these efforts and bless the Organization of Pakistan, bless all those who are in the background, and bless all those who attended, Ya Kareem, today, and all those who may be listening to this recording later. Wa-alhamdulillah, Ya Rabbi Al-Alamin, wa-sallallahu ma-ala Sayyidina Muhammad, wa-ala alihi wa sahbihi wa-sallam al-ajma'in. Amin.