American Civic Life

Is Ramadan More Challenging for Neurodiverse Muslims? Experts Say Yes.

Muslim woman praying silhouette on window. (	Jasmin Merdan/Getty Images)

Muslim woman praying silhouette on window. ( Jasmin Merdan/Getty Images)

Days often pass in a blur for Sumejja Pasanbegovic.

Hours go by and she is unable to physically move or get herself to run an errand, or pray, or read the Quran — all the things she had planned to do when she woke up. Sometimes, if she forgets the verses she recited a few seconds before, she cries on the prayer mat out of frustration, redoing the prayer repeatedly. She frequently cannot recall what she did for most of the day, or where the time went.

Pasanbegovic suffers from ADHD — attention-deficit/hyperactivity disorder, a neurodiverse condition that can affect an individual’s perception of time and ability to focus. It can manifest as obsessive compulsions, brain fog, rapid mood changes and other symptoms. It is one syndrome that falls under the loose term “neurodiversity,” which simply describes a variation in experience of the world, in school, at work or through social relationships. Autism spectrum disorders and dyspraxia are other common disorders commonly described this way.

For millions of Muslims around the world, neurodiversity can affect their ability to practice their faith, especially during the holy month of Ramadan, a time of intensive prayer, alone and in crowded and bustling rooms at the mosque.

“I absolutely face challenges practicing my faith due to my ADHD — particularly with prayer, keeping up with religious obligations and being mindful during worship,” said Pasanbegovic, who works at an Islamic elementary school in Toronto. “It’s a source of great frustration, guilt and shame. … Ramadan is about worship and taking advantage of the month to get closer to Allah, so that’s where my struggles happen.”

Mubeena Mirza, a clinical social worker, works with people with obsessive-compulsive disorder and anxiety disorders at Beach Cities CBT, a therapy center in Redondo Beach, California. She has seen an uptick of compulsions for neurodiverse patients during Ramadan, citing the anticipation of the excitement of the holy month, when Muslims often stay up all night praying, believing that blessings are increased tenfold during this time.

“While it’s normal to worry about fasting for long hours, or being too tired to pray,” said Mirza, “the worries are heightened for people with mental health issues who may not be able to fast regularly or pray all night. This often causes a lot of guilt.

“People think if they ask God for forgiveness their illness will be alleviated, but that’s not true,” said Mirza. “Some people’s brains work differently, and we need to give them the tools they need to function better. I see a lot of guilt in my Muslim patients and guilt can fuel mental illness, especially OCD and anxiety.”

The inability to focus on prayers or perform rituals at prescribed times can also lead some people to doubt their faith.

Mubeena Mirza. Photo via Beach Cities CBT

Muslim patients often worry, Mirza said, about whether they performed their prayers or ablutions correctly, and they ask her what their intrusive thoughts during prayers say about them. “We call it religious scrupulosity, where people doubt their faith due to their illness, and wonder if they’re practicing their faith correctly,” said Mirza.

“Their obsessions are doubts, and the compulsive behaviors that follow are ways to cope with their anxiety around their faith,” added Mirza. People experiencing these doubts worry they have committed some form of blasphemy and will spend hours praying for forgiveness or repeatedly washing their hands.

Mirza teaches these patients about radical acceptance and radical self-compassion. When a patient expresses intrusive negative thoughts, Mirza asks the person: What would you do if your friend or loved one was finding it hard to fast during Ramadan? Would you show them compassion? Why is it that you’ve so much compassion outwardly but it is hard for you show it inward?

“I try to remind them that from a religious perspective, God is forgiving, and that God knows you have mental illness,” said Mirza. “When they say it’s difficult to fast every day or stay up all night to pray, I remind them of God’s mercy, and encourage them to double down on the skills and tools they’re learning in therapy to take care of themselves.”

For some patients, navigating religious observances with mental illness can be an isolating journey.

When Pasanbegovic was diagnosed with ADHD last year, she searched “ADHD Muslims” on social media platforms but didn’t find the online community or resources she was looking for. Instead, she says she found posts on Islamic seminars claiming to cure ADHD and misinformation about various disorders.

“I remember feeling defeated, and very upset. I couldn’t find a community of people who understood my struggles, and I quickly grew quite tired of it and decided to try creating it myself,” said Pasanbegovic.

In December, she created an Instagram account called Neurodivergent Muslims, which has amassed more than 1,300 followers. She posts regularly about living with ADHD, often using bionic reading — text formatted in a way that highlights the first few letters of a word. Though there is little research available on the method, some studies show that people with ADHD perform better with reading tasks with bionic reading.

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“I get so many messages from people thanking me, telling me, in tears, that they’re so relieved that this page exists, that they feel seen and heard, that they’re so happy they’re not alone, and that it’s already helped them immensely,” said Pasanbegovic. “The response has been overwhelming and while it warms my heart, it also breaks it because I can sense how alone they’ve been and how they’ve been longing for a community, but I’m so happy I can provide that for them.”

Though research shows an estimated 15% to 20% of the world experiences some form of neurodivergence, there is still a lot of stigma associated with mental health that can keep patients from seeking out professional help.

Katie O’Dunne, an interfaith chaplain and founder of Faith and Mental Health integrative services, believes that having a community for support, both online and offline, can help patients learn to destigmatize their illness. She hosts Faith and OCD roundtable, a discussion with faith leaders, clinicians and individuals with OCD from various faith traditions, and leads a special interest group for people of faith to discuss their struggles.

“I think community is so significant, and it’s something that OCD very much tries to take away,” said O’Dunne. “Anything that we’re doing as a part of OCD relates us to fear, urgency, guilt, shame. I deeply believe that the things God is leading us toward have to do with joy, meaning, connection, and finding peace and love in community. So, I think moving towards that as opposed to what OCD is telling us is what we need to do.”

In addition to finding community, O’Dunne believes education and awareness about neurodiversity and its impact on faith are important. She encourages community and faith leaders to learn how mental illness such as OCD can manifest in diverse faith traditions so they can raise awareness in their communities.

In partnership with the International OCD Foundation, O’Dunne created a Faith and OCD Resource Center, which offers patients, as well as faith leaders and medical providers, resources and a platform to learn more about OCD and how it shows up in diverse faith traditions.

“We tend to be so hard on ourselves and we tend to assume that we are not enough, or that we are imperfect,” said O’Dunne. “I always remind folks that God created you, and you’re imperfectly perfect and God loves you. There is no shame at all in what you’re experiencing, you’re not alone, there is so much hope for getting better, and you deserve to get better.”

How much do you know about Ramadan?