The effects of fasting during Ramadan on mental health
Just around the corner is Ramadan, the holiest month in Islam.

The holy month is not merely about abstaining from food and drink from dawn till dusk.

It is a profound spiritual journey that offers numerous benefits for mental health and wellbeing.

Muslims around the world are getting ready to embark on a transformative experience that nourishes not only the body, but also the soul and mind.

One of the most remarkable aspects of fasting during Ramadan is its profound impact on mental health.

While the physical benefits of fasting are widely recognised, such as detoxification and improved metabolic health, the psychological benefits are equally significant, if not more so.

Mental benefits

Ramadan fosters a sense of discipline and self-control, which are essential components of good mental health.

By refraining from indulging in food, drink and other worldly desires during the daylight hours, individuals learn to exercise restraint over their impulses and desires.

This practice instils a heightened sense of self-discipline, which can translate into better management of emotions.

Moreover, fasting encourages mindfulness and introspection, creating an opportunity for individuals to reflect on their actions, behaviours and spiritual needs.

The act of abstaining from physical nourishment allows one to delve deeper into their inner thoughts and emotions, fostering a greater sense of self-awareness and spiritual connection.

This introspective journey can lead to profound insights, emotional healing and a heightened sense of gratitude for life’s blessings.

The fasting month promotes community and social cohesion, both of which are vital for mental wellbeing.

The shared experience of fasting brings people together, fostering a sense of belonging and solidarity.

Through communal prayers and buka puasa meals, individuals strengthen their bonds with others, reducing feelings of isolation and loneliness that can contribute to mental health issues.

Ramadan also emphasises empathy and compassion towards those less fortunate, promoting acts of charity and generosity.

Engaging in charitable deeds and helping others in need not only benefits the recipients, but also brings immense joy and fulfilment to the giver.

Such altruistic actions can boost endorphins – our “feel-good” brain chemical, which also helps to expel stress and helps us detach from negative feelings such as anger, thereby boosting mental wellbeing.

Ultimately, Ramadan fosters a sense of purpose and meaning in life.

Considerations for fasting

Fasting during Ramadan is one of the five pillars of Islam, so it is considered obligatory for all Muslims who are healthy enough to fast.

However, there are exemptions from fasting, such as for the pregnant, the elderly, people with acute illnesses, and those with chronic conditions that are likely to be exacerbated by fasting from sunrise to sunset.

Mental health conditions are among the reasons that people may not be able to fast.

The problem is that, for many people, there is still a huge stigma in admitting that they are having mental health problems.

Sometimes, people would rather fast and feel ill than reveal that they are being treated for mental illness.

Some feel very strongly about observing the fast, even if they know that their condition would mean they are exempt.

It is a deeply personal decision, so the advice here is intended to help such people make that decision for themselves.

What factors should those with mental illness consider when it comes to fasting for Ramadan?

Firstly, those with mental health challenges need to determine if their condition is stable at the moment.

If they have recently had a relapse, had an increase in symptoms or experienced an episode of their mental health problem, fasting may not be a good idea this time as it can lead to further destabilisation of their condition.

For somebody who is struggling with bipolar mood disorder or schizophrenia, fasting can affect the efficacy of their medication, meaning that a relapse is more likely.

Poor sleep and the change in routine can also heighten the risk of relapse, so fasting may not be an easy decision to make.

If they do decide to fast, they need to do so with the support of their prescribing doctor.

Their close ones also need to know what warning signs to look out for.

According to the rules of fasting during Ramadan, medications that are in tablet or liquid form need to be taken outside the hours of fasting.

However, injections into the muscles, or patches where the medicine is absorbed through the skin, are generally seen as permitted to be taken any time during Ramadan.

If someone has to take medications three or four times a day, altering the times they take their medication can be considered, but should only be done in consultation with their doctor.

Some psychotropic medications are available as slow or modified release forms, so these may be more suitable for patients who want to fast during Ramadan.

Blood tests are allowed during Ramadan, so those on medications such as lithium can continue to have blood tests to keep track of their medication levels.

Fasting blood tests may need to be arranged at a different time to the usual if the patient has the sahur meal and take their medication at that time.

They need to inform their doctor that they are fasting when the appointment is booked so that it can be arranged at an appropriate time.

Smoking and eating disorders

Ramadan is often the best time to kick the habit of smoking altogether.

However, for those on certain types of psychotropic medications, completely stopping smoking may increase the blood levels of drugs like clozapine and olanzapine.

If such individuals still smoke from sunset to dawn, it may not affect their medication efficacy.

However, such crucial decisions are best made after consulting their psychiatrist.

Meanwhile, for those who have an eating disorder or have had a pattern of disordered eating in the past, fasting can be fraught with triggers and potential for relapse.

They need to keep in mind that any change in eating patterns has the potential to set off a self- destructive chain of thoughts, feelings and behaviour, as fasting is a huge change to the normal eating pattern.

Those who are receiving continued mental health support would need to consult a mental health professional on what is the best way to avoid a potentially fatal outcome.

A chance to reset

The holy month of Ramadan is an opportunity for individuals to address any unhealthy behaviours.

It is an excellent time to reflect upon and evaluate harmful habits such as smoking, consumption of alcohol, taking recreational drugs and excessive internet use, which can be amended during this month.

In addition, the ability to avoid unhealthy behaviours for an entire day for a whole month can be a stepping stone towards resetting and building up resistance to triggers, even beyond Ramadan.

In essence, fasting during Ramadan is not just a religious obligation; it is a holistic practice that nourishes the mind, body and soul.

By cultivating discipline, mindfulness, community and compassion, Ramadan offers a transformative experience that promotes mental health and emotional wellbeing.

As individuals embark on this spiritual journey each year, they emerge with renewed strength, resilience and inner peace, ready to face life’s challenges with grace and gratitude.

Prof Datuk Dr Andrew Mohanraj is a consultant psychiatrist, the Malaysian Mental Health Association president and Taylor’s University Impact Lab on Mental Health & Wellbeing director. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Matters of the Mind,Ramadan,fasting,mental health,smoking,eating disorders
Fasting and self-reflection during this holy month for Muslims provides an opportunity to reset one’s mental and emotional wellbeing.