Omar Reda, MD

The Muslim community in Texas was shaken to its core by the news of a murder-suicide of a whole family on April 5, 2021.

Apparently, 2 young Muslim boys decided to kill their parents, their sister, and their grandmother, before killing themselves. One of the brothers left a chilling and troubling note listing some of his reasoning for committing such a horrifying act. He mentioned feeling empty, that life had no meaning; he talked about depression as a lonely and alienating experience, that having a supportive family can be a protective factor, but only to an extent. He even briefly described gun control in America as a joke—getting access to lethal weapons was not that difficult for him.

Religious leaders and mental health professionals have been quite vocal about showing moral and material support for the local community, especially the youth. They are also using this incident as both a learning curve and a teaching tool for the larger Muslim community, with the hope that lessons learned might help the future design and delivery of culturally appropriate services and resources, an approach that might help prevent or at least reduce the odds of having similar incidents in the future. This is an emergency that the Muslim community needs to urgently and immediately address.

Spirituality can be a protective factor against suicide. Like any other religion, Islam is practiced on a spectrum. With a population of more than 1 billion Muslims, there are diverse reactions and responses to challenges within the Muslim community. Some of the research I came across showed that the overall rates of suicide were lower among Muslims than non-Muslims, but there are many factors that come into play here, like cultural cohesion, familial bonds, and social support, which are highly valued components of the Islamic faith. Talking about religion needs to be tactful when approaching the topic of depression and suicide. Those with mental illnesses should not be judged as having weak faith or a poor relation with God; rather, we need to extrapolate using examples from the Quran and the life of Prophet Muhammad that focus on self-care, the reward of mending broken hearts, and bringing healing to injured souls.

Imam Yasir Qadhi, PhD, a prominent scholar in Dallas, Texas, gave a heartfelt talk to help shatter taboos about mental health and emotional wellness, and to address misconceptions that are quite prevalent in the Muslim culture, despite having nothing to do with the authentic teachings of the religion that encourage stress management, emotional-expression, and speaking up. Here are some of the points that sheikh Qadhi covered in his 

1. As written in the suicide note “who knows, some good might come” out of this tragedy. Hopefully there will be more education and awareness about the prevalence and magnitude of the issue of depression in Muslim teens.

2. We need to show sensitivity and respect to the family. We are in no position to pass judgment, as the “fate of those involved will be determined in the divine court.”

3. In some form or another, everyone who died was a victim. This is not to justify the homicidal or the suicidal act, but rather to try to understand the bigger picture from a trauma-informed perspective.

4. Humans tend to try to process and make meaning out of suffering. Sometimes it is difficult to comprehend the reason or “the divine wisdom” behind such traumatic events.

5. These community discussions can feel awkward, but they are essential and overdue.

6. We need to aggressively advocate through educating community members that mental disorders are as tangible as physical ones. When afflicted with cancer, broken bones, or bleeding wounds, patients are rushed to the emergency room; emotional injuries should not be treated any different.

7. Desperate people do desperate things. When they reach a point where life becomes meaningless, they might become unreachable. Hopelessness and loneliness are awful feelings. Try to be a light source, mend broken hearts, show up for others, tell those around you that “maybe I do not understand your pain, but teach me, I am here for you.” A simple act of kindness like a smile or eye contact might brighten someone’s day—or even save their life.

8. People cannot just snap out of depression. The mental box is different than the spiritual one, and both boxes need to be filled. Prayers are wonderful, but they are one tool of many.

9. Adults should not shut down or dismiss pleas for help. Many parents do not know how to talk to their teenage children. Although there is a lot of silence in Muslim household, this is not a Muslim-only phenomenon—youth depression and suicide are invisible global pandemics.

10. Tragedies such as this one should serve as a wakeup call and motivate the community to act. Mental health staff and religious leaders need to come together to address short- and long-term solutions, as well as action steps. Bottled up emotions should not be the norm. Our children are our top priority. Muslim homes and houses of worship should be seen as a refuge, not a prison, and should always feel like places of safety.

The 13th century Persian poet Rumi eloquently wrote that “there are beautiful things that you can only see in the dark.” There is always some good that comes out of trauma—the Muslim community is forced now to have difficult, but honest and healing conversations.

There are culturally humble and responsive services and resources that are made available for the community. Here are few examples:

is a practicing psychiatrist, Providence Healthcare System, Portland, Oregon.

Articles

A tragedy has rocked the Muslim community. How can psychiatry try to help prevent further tragedies from occurring? 

More Than a Murder-Suicide

For the most part, the field of psychiatry has looked on organized religions with suspicion, even though majority of sacred texts have paid special attention to emotional wellness and holistic health.

Coming from a Muslim background, I have used my religion as a grounding and healing tool for myself, my family, my small community, and for clients who requested to use God’s words (the Noble Quran) and the authentic teachings and traditions of Prophet Muhammad (peace be upon him) as part of our therapeutic relationship.

It is usually much easier to introduce religious themes with terminology like “spirituality” and “tending to the soul.” The youth in particular seem to have a difficult time reconciling the religious aspect of their personality with societal expectations. I have asked questions to Muslim youth and their caregivers, but my understanding from Jewish and Christian friends and colleagues is that there are similar themes in all 3 monotheistic religions. However, most of the Muslim community’s negative feelings around Islamic organizations and places of worship comes from a heavy legacy of trauma, caused mainly by the culture of the leadership and from the out-of-context quoting and misinterpretation of a sacred text.

Here are 25 of the most criticized attitudes and practices when it comes to Islamic centers:

1. Lack of trust between the community and its leaders

2. Lack of demographic diversity and representation, especially in positions of leadership

3. Systemic exclusion of certain sects of the community

4. Lack of attractive alternatives to the mainstream culture, especially for the youth

5. Gross violations of the rights of some worshippers, like those with mental disabilities

6. Lack of transparency and culture of secrecy

7. Double standards when treating Muslims and non-Muslims

9. Culture of competition, rather than collaboration

10. Poor interfaith and outreach to the larger non-Muslim community

11. Lack of flexibility of policies and procedures

12. Harsh approach to giving and receiving advice and feedback

14. Not taking advantage of the talents, skills, and expertise of most worshippers

15. Poor sustainability of programs and resources

16. Reactive, rather than proactive, response to issues

17. Spreading a punitive message of despair, rather than advocating for hope and beauty

18. Weak societal impact, possibly stemming from the attitude of “going back home one day”

19. Rigid adherence to a certain style or school of thought

20. Rare access to new blood and young leaders who speak the cultural language

21. Poor understanding of the American cultural norms, laws, and systems

23. Misusing religion to justify dysfunctions like domestic violence and child abuse

24. Double standards when treating men and women, and boys and girls

25. Minimal representation of Muslims in the media and in politics

Psychiatrists can bridge gaps between the community and religious leaders through psychosocial education that targets stigma, that in turn helps with opening channels of communication and building bridges of trust. I have been blessed to earn the trust of both the Imams and the Muslim community in Portland, Oregon, and it is now common to hear discussions inside the house of God about family dynamics, self-care, emotional intelligence, trauma healing, suicide prevention, and many other psychosocial topics that were otherwise censored.

In Islam, the relationship between the Creator and His creation is a personal and intimate one, you can see the face of God not only in the mosque but in every beautiful act of kindness towards others, the best way to worship the Lord is to serve humanity.

is a practicing psychiatrist, Providence Healthcare System, Portland, OR.

One doctor shares his experiences with religion’s role in the practice. 

What Does Psychiatry Have to Do with Religion?

Many psychiatrists seem to have accepted, and are content with, the narrow scope of practice imposed upon them. For myself, however, I refuse to reduce the unlimited potential of psychiatry to merely prescribing psychotropics. Medications can be quite effective, even lifesaving, but they are not the only tool we can offer our clients.

I have been reflecting on the psychosocial impact of the COVID-19 pandemic, especially on our youth, and would like to share few thoughts that might provide hope for these beautiful, little creatures.

This writing is not intended to be a naive generalization or an over-simplification; I have used an easy language here with the goal of having these tips shared with clients, especially parents and caregivers. I hope they can also help you when taking care of your family and community, and even serve your own self-care and healing.

The wounds of trauma are, for the most part, invisible. They can scar our bodies, minds, hearts, and souls. There are many hormones and chemicals involved in responding to adversity, especially protracted stress like the current pandemic. I will briefly mention 5 of those.

The hormone adrenaline (also known as epinephrine) is commonly known as the emergency hormone. It helps anticipate and prepare for threats, or activates fight or flight responses. That is helpful, and even critical short-term, but can have long-lasting negative consequences if we remain in a state of arousal, fearing an actual or a perceived threat. One way we can help children and those around us cope is to calm our mind and manage our anxiety. This can be done in many ways like meditation, mindfulness, and engaging in activities that are physically and mentally cathartic.

The hormone cortisol is commonly called the stress hormone. It helps us respond to stress, but it can also be harmful in the long run. One way to balance cortisol levels is to be kind to our bodies through mastering consistent healthy eating, sleeping, and lifestyle habits.

I want to focus now on 3 other chemicals, collectively known as the happy hormones. Dopamine (also known as the thrill hormone) is not only involved in addiction, thrill-seeking, and impulsivity, but is also a vital hormone for our emotional wellbeing. When it comes to children, we can give them a dopamine boost by simply paying attention to them. Children thrive when they feel noticed, therefore we should take every opportunity to let them know that they are seen, heard, and felt. Youth who feel safe seem to blossom, and start to believe in, and express, their beauty.

Serotonin (commonly known as the happiness hormone) is not only involved in depression, but it is also a chemical that is released when we feel valued. It is important to show appreciation to young people. When they trust in our unconditional love, they will start to believe in their own abilities, which boosts their self-esteem.

And lastly oxytocin (the love hormone) is released when children feel loved. One way to boost this hormone is to express affection towards them. Simple acts of grace and gratitude can work like magic. These can include eye contact, safe touch, smiling, kind words, and spending quality time with them.

I am a big fan and an outspoken advocate of taking care of young bodies, minds, hearts, and souls. When it comes to children, we would literally die to protect them from assaults and shield them from insults, yet many of us engage in verbal attacks and acts that verge on being abusive or neglectful towards them. I know that we are all trying our best given our circumstances, but when it comes to our loved ones, we can always do better.


To prescribe the hormones of happiness, try the Triple-A Approach:, pay attention, show appreciation, and express affection towards the people who matter most. Small moments can make all the difference.

is a practicing psychiatrist in Providence Healthcare System, Portland, OR.

One doctor gives his recommendations for attending to children’s happiness.  

Moral Duty Beyond Prescribing Medications

I have, maybe even more than my children, thoroughly enjoyed watching the Pixar Animation Studios’ film 

. Per Disney, “Soul is what makes you…YOU.” 

 is not only about finding your own passion, but also helping others find theirs.

Soul is a mysterious concept. It is more than just our heart, psyche, or spirit; it is the deepest and most intimate part of who we are. Soul is what makes us humans.

The year 2020 launched a brutal attack on our souls. The invisible scars of moral fatigue and the soul ache we are left with are constant reminders that caring comes at a cost. That is why, as a caregiver, I urge you to tend to your soul.

Find out what makes your soul sink. This can be unhealthy coping styles, unhelpful beliefs, and dysfunctional behaviors. Many caregivers act as if their feelings do not matter, as if they should ignore their needs, deny their pain, brush off their trauma, wipe away their tears, and just get up and keep going. The culture of caregiving is rampant with dark secrets, toxic stress, and silent suffering.

But that does not have to be the case. Caregiving can and should bring joy, not only pain. It brings joy when we look for and celebrate what makes our soul sing. This can include selfcare, social bonding, and engaging in deep kindness. I found family, faith, practicing gratitude, and performing acts of service to be extremely helpful in nursing my wounds and healing my compassion fatigue. One of my New Year’s resolutions is to show more appreciation to my loved ones and the things I take for granted, and to engage in activities that help people find meaning, healing, closure, and beauty.

My request for you is to do the same. Practice love, mend broken hearts, speak up for the voiceless, bring people out of the shadows, listen to the suffering behind closed doors, but also make sure that you tend to your soul.

The recent Disney Pixar film has a doctor contemplating what makes us all unique, and how we can care for ourselves. 

Tend to Your Soul

There is a common saying that if the care we provide our clients is not culturally sensitive, then it is not trauma-informed.

I am a big believer in meeting our clients’ cultural needs, and in respecting and celebrating the beauty of their traditions. However, we need more than superficially pleasant interactions with individuals from diverse backgrounds, individuals who we label as “different than us” because of the way they look, talk, or practice their culture or religion.

Trauma sensitivity alone, I believe, is not enough. We need culturally responsive and effective care. I will give an example here, then expand on how to put this concept into action.

I recently walked into the inpatient unit where I work to find that my staff had called security and were about to inject or seclude a large, agitated black man. I asked if I could try to talk to him. As I listened, he asked that he only work with staff of color, asked for a menu fit for a Muslim man who only consumes halal/kosher meat, and asked if he could talk to an imam to learn how to pray again. We ended up not needing restraints or antipsychotics after all; all he needed that morning was human connection. I happen to share aspects of his cultural background, and that made him feel safe enough to open up to me.

It is not going to be possible to have non-white staff assigned to him all the time, but on this particular day that plan worked best.

There are 4 things to remember when bearing witness to individuals in distress:

1. Authenticity. Our clients will quickly discover if we genuinely care.

2. Curiosity. Show interest in them as humans, not only the labels assigned to them.

3. Flexibility. We must be ready to adjust our way of thinking, and in doing so, we can better meet their needs.

4. Humility. Maintain the attitude of a student, keen to learn from each encounter.

Psychiatry is not only a field of suffering or an industry of pain; there is also a lot of joy that we should get out of caregiving. If you are not looking for beauty in every interpersonal encounter you have with those you serve, then you have not yet touched the soul of medicine. By listening to and meeting patients’ cultural needs, we all win.

Sometimes the best medicine is understanding. 

Rx: Meeting Cultural Needs 

 interviews Omar Reda, MD, about international medical graduates (IMG) and his own personal and professional journey. In this podcast he discusses:

1. His childhood and medical training in war-torn Libya

2. The challenges facing immigrants who want to become doctors in the United States

3. How his colleagues, and the American medical establishment at large, can help IMGs realize their dreams

Podcasts

In their quest to become American doctors, international medical graduates face formidable obstacles. A psychiatrist from Libya explains how his colleagues can help them along the way. 

The Road Less Travelled: An Immigrant’s Story

Videos

Question and consider how people adapt, how families/communities cope, and how physicians should engage with trauma. 

Trauma Informed Care

The field of psychiatry needs to pay close attention to the long-term psychosocial impacts of trauma, not only on trauma survivors as individuals, but also on their families and communities.

Trauma that affects 1 member of a family system has the potential to fundamentally change the whole family structure. It threatens to erode the very foundation of the family unit, and family members may start to see each other as enemies. 

 has the power to make or break a family.

, out of cultural taboos and stigma, is seen as a source of shame and kept a secret, it can manifest in different ways, especially relationally, leading to a dysfunctional environment of toxic stress and silent suffering, a deadly web many families find themselves tangled in.

Early prevention is always better than late intervention because trauma can span generations. Trauma survivors can repeat the cycle and become part of the problem, or they can become part of the solution by investing in their families, normalizing the process by speaking up, and expressing emotions. To continue to choose the narrative is to choose to continue the vicious cycle and feed the fires that eventually destroy everything in their way.

Trauma that happens to children can shatter and confuse core beliefs they hold about themselves and the world. Children need to believe that the world is a safe place and that adults can be trusted to care for them. When these foundational basic needs are violated, these young beautiful creatures lose hope and start to wrestle with existential issues, doubting their own self-worth and beauty.

Psychiatrists working with traumatized populations need to establish safe spaces that serve as platforms where people can regain their voice and reclaim their narrative. Through encouraging and supporting open channels of communication and building bridges of trust, they help break the cycle for their clients, and that in turn helps bring hope in healing.

Interpersonal trauma that casts dark shadows on our beliefs about our innate goodness and shared humanity is arguably more harmful to the psyche than a largescale destruction caused by natural disasters. But the trauma story, if viewed as a learning tool, can help us become more resourceful and resilient.

We owe it to our loved ones to break the cycle. Not everything we inherit is worth passing to our children, especially not our trauma story.

Post Traumatic Slave Syndrome: America's Legacy of Enduring Injury and Healing

From Generation to Generation: Healing Intergenerational Trauma Through Storytelling

Trans-generational Trauma and the Other: Dialogues across history and difference

Patients want to pass on many things to their children; trauma is not one of them. 

The Unforgiving “Gift” of Generational Trauma

Omar Reda, MD, emphasizes several points in his video on how to take care. Here are some suggestions:

-Consider all parts of your health. Dr Reda cites 4 focal points: body, heart, mind soul. Are you caring for each part of yourself, or focusing on only 1 or 2?

-Improve your family dynamic. Pay more attention and appreciation to your loved ones. Make eye contact and establish safe touch. Ensure you are spending meaningful time with your family. 

-Take breaks. When you take them, are you actually relaxing? Be sure to carve out time to truly unwind. 

is a practicing psychiatrist in Providence Healthcare System, Portland, OR. He reports no conflicts of interest concerning the subject matter of this article.

Times are hard but they are easier if we get through them together. Omar Reda, MD, provides activities and insight on ways to actively care for yourself and your family. 

How We Can Take Care of Each Other 

Not only in America, but throughout the world, difficult conversations are taking place in many homes. Behind closed doors, children are exposed at early ages to discussions about heavy topics like violence, hate, and human cruelty.

I am blessed to have three daughters. I try to create a safe and sane home for them, but I have never imagined engaging them in some of these talks, especially here in the United States, and in the 21st century.

When I moved to Portland, Oregon in 2009, I thought the city’s nickname (the Rose City) was a sign that things would be much safer and more comfortable for my family. Similarly, my wife believed that moving from the southern to the northwestern part of the country would make things easier for us as 

But shortly after arriving, a young Somali boy was accused of planning a terrorist attack in one of the city’s busiest spots, the Pioneer Square. We found ourselves working with community leaders and the Muslim youth on topics like emotional safety and well-being, how to be a proud American Muslim, strengthening family ties, and improving the relationship between the community and its neighbors and law enforcement agencies.

Fast forward to 2011, a bloody civil war started in my home country Libya. I left my small immediate family behind to care for my extended family overseas, trying to heal some of the many psychosocial wounds of that protracted conflict. I lost friends and loved ones to violence and extremism. My wife and children had to live through periods of uncertainty and high anxiety every time I boarded a plane and partook in that dangerous journey.

We thought and prayed the new decade would bring a better energy, but the year 2020 has been one of the most challenging years of all. Here in Oregon we have been struggling to breathe, literally and metaphorically. It is not only the threat of the 

 (COVID-19) to our respiratory system, but also the systemic knee of injustice on the necks of our black brothers and sisters and the wave of hate facing minorities and people of color. The mask can help with the former crisis, but unmasking is what is needed for the latter.

It became the norm to talk with kids about their identity and self-worth, about micro- and macro-aggressions, about speaking up on behalf of the voiceless, but also about how they can defend themselves when someone decides to attack them verbally or physically. After the Portland max train stabbing incident and the New Zealand mosque shooting, we spent time and energy brainstorming ways on how to stay alive and feel safe at our places of social gatherings and worship. Trauma steals precious moments and impacts the potential for beauty.

I recently participated on a panel discussion about combating hate. A young black female stated that, “at least [things] are not as bad for this generation as it was for our fellow citizens in the 1950s and 60s.” That really broke my heart. Just because hate and violence are “not as bad,” does not mean things are OK. Children should not have to settle for a dysfunctional world.

“The talk” we thought we would have with our children is about how to survive the emotional turmoil of puberty. In the black community, that talk is also about how to stay alive in America. In the Latino community, it may be about the immigration system. In the Muslim community, it may be about terrorism. Hate is horrible, and it not only makes survivors doubt their own beauty, but it also makes us miss out on each other’s beauty.

We thought COVID-19 was only going to impact our ability to breathe, but then Mr Floyd’s death reminded us of the ugly pandemic of oppression. In Oregon, the smoke of the wildfires stirs different discussions about existential themes, like our relationship with God and the meaning of life.

Is it bad that our children are growing up very quickly and having these mature conversations at a young tender age, or is that the new norm? My hope is that trauma will eventually produce a more resilient generation and a more compassionate and cohesive society, I believe that many trauma survivors become better humans not despite, but because, of their trauma stories.

This article was originally posted on September 21, 2020, and has since been updated. -Ed

With the state of the world, there are so many difficult conversations about racism, hatred, and violence that we need to have with our children. 