E

very year, Muslims celebrate a whole month of fasting called Ramadhan. In this holy month, Muslims refrain from food, drink, sex and tobacco from dawn (subuh) until dusk (maghrib). Every adult Muslim must undertake this ritual as a religious obligation, except for the sick; women who are menstruating, pregnant or breast-feeding; and the elderly.

Fasting is not only about shifting the pattern of intake from the daytime to the hours of darkness; every Muslim has to control their emotions in Ramadhan to get through the fast. However, it is very hard to cope with stress and to control our emotions when our stomachs are empty.

Humans are exposed to many stresses. The stress in turn is a major risk factor for the development of physical and psychological illnesses. Therapy for stress disorders is focused on coping strategies. This hypothesis leads to the idea that the severity of stress is not solely due to the stress itself, but it largely depends on the way of evaluating and coping with the stress.

One effective method of coping with stress is through religion — a behavioral-cognitive method to overcome tension and physical and psychological discomfort.

Ramadhan fasting can influence the psychological status of Muslims. Different studies regarding the effect of fasting on physical and psychological status have been performed. One review said that coping with stress was largely dependent on religion. As Muslims pay more attention to their religious tasks during Ramadhan, it is believed that their physical and psychological status can be affected positively during the holy month.

M. Kazemi from Iran conducted a research on relationship between fasting and emotions in 2004. He studied the effect of Ramadhan fasting on the psychological health and depression in university students. Three-hundred-sixty-one students were randomly selected and their demographic information was collected. The data were collected on two different occasions, 10 days before and 10 days after Ramadhan.

The results said that the psychological health of participants before Ramadhan increased and their depression decreased after Ramadhan. The differences were statistically significant. The conclusion of the researcher was that Ramadhan fasting can be an important factor for improving mental health and for eliminating of depression.

Another study on the relationship between fasting and self esteem was conducted by Javanbakht in 2007. This study was carried out to clarify the effects of Ramadhan fasting on self-esteem and mental health.

This descriptive-comparative study surveyed 60 apparently healthy medical students (38 female and 22 male) who decided to fast during Ramadhan in 2007.

The students in the sample completed the demographic and Cooper-Smith self-esteem and Symptom Checklist-90-Revised (SCL-90-R) questionnaires at the beginning of Ramadhan and after at least 21 days of fasting. The answers were compared with those from the beginning of Ramadhan. Students’ self-esteem increased after 21 days of fasting.

Some dimensions of human emotion were also significantly diminished, such as depression, anxiety, obsession, interpersonal sensitivity, phobias, hostility and paranoid thinking. The conclusion was that Ramadhan fasting improves human self-esteem and mental health.

Michaelsen from the Kliniken Essen Mitte, Germany, stated that short-term fasting leads to mood enhancement and emotional harmonization. Michaelsen investigated psychosocial well-being and the neuroendocrine response, assessed by nightly urinary excretion of cortisol and catecholamines hormones in 28 inpatients with chronic pain syndromes during and after a one-week modified fast.

Mood and well-being increased non-significantly in both groups. The results show fasting was well tolerated, and regarded as beneficial by most of the patients.

Another study that shows the benefit of fasting on human emotion was conducted by Goldhamer in 2004. It was found that fasting greatly reduced the length of time addicts of nicotine, caffeine, cocaine and alcohol suffered withdrawal symptoms. Some people only think that the benefit of fasting is to decrease weight. But according to research by Salloum, the greatest benefit of fasting goes beyond decreasing weight, increasing relaxation and saving money.

According to Salloum, the greatest benefit of fasting is the satisfaction in improving one’s health.

From the stand point of biology, it is believed that cortisol rises as an adaptation phenomenon to control emaciation in fasting people. On the other hand, cortisol can also be a stress hormone which allows for physical and psychological adaptation with stress.

Besides that, plasma level of beta-endorphin rises in fasting people. High levels of endogenous opioids could decrease the desire and crave for abusive substances such as methamphetamine.

Although most of the research showed an improvement of emotional control after fasting, the Minnesota Starvation Experiment study in 1945 stated a different point of view. It stated that prolonged semi-starvation produces significant increases in depression, hysteria and hypochondriasis as measured using the Minnesota Multiphasic
Personality Inventory.

Most of the subjects experienced periods of severe emotional distress, depression, social withdrawal and isolation. The participants reported a decline in concentration, comprehension and judgment capabilities, although the standardized tests administered showed no actual signs of diminished capacity.

Finally, Ramadhan fasting can give us many advantages, not only to our physical health but also to our psychological health. We can reshape and rebalance our body and emotional health in this holy month. Happy Ramadhan fasting!

The writer, a medical doctor, lives in Jakarta.