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Chronic Illness and Ramadan: Coping Tips and Strategies

Published

June 30, 2014

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By Merium Khan

I still remember the moment vividly: I was 13 years old, and at a Muslim youth camp. A fellow teenage camper was talking about Ramadan when her voice started to tremble. As she described her inability to fast due to medication, the tears started to flow and her voice dissolved in grief. It was so poignant, but being a young, healthy person, I couldn’t possibly truly understand that sense of loss she felt—until recently.

A few years ago at the age of 25 I was diagnosed with multiple sclerosis and found myself unable to fast.

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During the first Ramadan that I could not fast due to the illness, I faced the stark reality: I would likely never fast again for the rest of my life. Long night prayers would be lost to me as well, as lack of sleep would exacerbate my symptoms just as surely as lack of food.

My mind flashed back to that fellow camper from years past, and I finally truly understood. Like her, I found moments when grief overwhelmed me, such as the time at a friend’s house when I hung my head, sobbing, until her 7 year old daughter patted my leg and said, “Khala, Allah understands…He understands.”

Since then, I have wished that somewhere buried in those “How to be a Super Muslim During Ramadan” articles and khutbahs, there were more useful Ramadan resources for Muslims with a chronic illness. We eventually just learn to stumble our way through the month, and after crossing off the things we can’t do, learn to figure out what we can do and how to survive the month without worsening our illness.

These are a few lessons I have learned these past few Ramadans as a young, non-fasting person:

Ramadan Prep:

The weeks before Ramadan require extra rest. Don’t skip it; take it like a medicine otherwise you’ll have less energy when you need it in Ramadan.

Conserve Energy:

Don’t use up all your energy in the beginning of the month. If you end up staying up too late, attending or hosting too many iftars, or otherwise overdoing the stress on your body in the first part of the month, forget about having the strength to do any ibaadah (worship) in the last ten nights (ask me how I know!).

Pay Your Fidyah:

Have your fidyah arrangements planned out ahead of time and pay it promptly. Fidyah is the payment for missing the fast, and the details are beyond the scope of this article.

Illness and Ramadan-Move Beyond Your Grief:

It’s okay to mourn what you have lost (ability to fast, to pray at night, etc.) but don’t let that be a trick to prevent you from doing what you actually are able to do. I realized that with a shock one year when, after playing pity party for the first week of the month, told myself, “Wait. You can’t pray qiyam, but you sure can pray your five prayers awesomely. Why aren’t you doing that at least?”

Reading and listening to extra Quran, making extra dhikr are also acts of ibadah that can benefit those who may not be attend taraweeh or qiyam.

Consider priorities:

You may have to turn down some or all iftar invitations to preserve your health for prayers and worship. This is especially true in the summer months when iftar time is late. Don’t let cultural or social pressures cause you to compromise on your health, especially during such an important month of worship.

Use Post-Iftar Time Wisely:

This is tricky but essential: when Isha is late, any taraweeh or qiyam can become a difficulty if not a near impossibility. This is particularly true for those whose illnesses will be exacerbated by lack of sleep and rest. Being able to restructure the time to get down to worship between Maghrib and Isha is going to be important during these summer months. I’ve found it difficult to apply this (especially as a wife/mother), because there’s such a rush between Maghrib and Isha and so much to get done.

Watch How Much Time You Spend Eating:

One of the things I remember about fasting is how much more time there seems to be in the day when you’re not spending any on food and drink. So for those of us who cannot fast, we can reconsider how much time we choose to spend on eating during the Ramadan days. This doesn’t mean skipping meals, but perhaps minimizing meal prep times, or skipping the non-essential snacks and “comfort foods” that may take up time to prepare and eat but are not essential to our health (like a leisurely snack of tea and cake). This frees up valuable time for worship.

Don’t be Shy to Get Help:

Your caregivers and friends are still there to help and support you, even when they are fasting. There is this tendency, since we are not fasting, to not ask others for help because they are fasting and we don’t want to burden them. This can lead to burnout and disease flare-ups, so we have to be open and ask for help when it’s needed even though we may feel bad about it. For those of us who have family responsibilities, it is important to be honest about our limits.

My husband will ask me in all honesty: “Can you do _________, or are you too tired?” and he trusts that I will be candid and not try to push myself to be the “Super-Wife.” This however has taken a lot of communication on my part, and understanding and compassion on his. It means that he has to eat a solitary suhoor, and sometimes even a solitary iftar on occasion if I am not feeling well. I have had to learn to put away my desire to do things perfectly, and allow him to help and support me in order to be well.

The Final Stretch:

All those beautiful and inspiring articles about how you’ve got to push your hardest, turn the last ten days into a sprint for the finish, and do what you’ve never done before? Lovely for the average folk, but it’s not going to apply to you if your illness is of the type that flares up due to lack of rest. Take the advice that will benefit and craft your own schedule. You’re not in Ramadan to aggravate your illness; rather you need to worship Allah in a way that recognizes that your body has a right over you. Always look for quality over quantity.

Ramadan conjures up so many feelings for those who deal with illness. There is the loss of the ritual worship (fasting, sometimes Qiyam), and even some of the usual habits and routines require change to accommodate life with an illness. It leaves a person with a sense of loss, and yet eventually we learn to create our own Ramadan routine that will allow us to participate in the month and yet stay healthy.

If your heart aches over the loss of fasting, remember this: the One who has ordained fasting has also ordained for you this illness as a test, so rejoice in the fact that there is mercy and wisdom behind his decrees. I take comfort in the fiqhi ruling that states that whenever fasting becomes harmful for a person, then in that case, fasting actually takes the ruling of haraam (forbidden). Therefore, by abstaining from fasting, I am preserving my health and, Allah willing, earning reward by avoiding this harm on my body. In the end, there is always some divine wisdom that we may never see:

“And Allah knows, and you know not” (al-Baqarah: 216).

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25 Comments

Sabeeha

June 30, 2014 at 2:12 PM

This brought me to tears. I too have multiple sclerosis and feel ‘less’ because my fatigue makes me unable to do the things I used to be able to. JazakiAllah Khayr for this.

Reply
- reshma naheed
  
  July 1, 2014 at 1:01 PM
  
  JazakAllah khairan.i suffer from acute depression & when im fasting continuouslythere’s an inner voice saying break d fast drink water.im very guilt conscious.What to do
  
  Reply
  - Sari
    
    July 2, 2014 at 7:55 AM
    
    I am suffering from depression as well. My Dr has stopped me from fasting. You should do as your Dr says. It’s Zulm to force our bodies to do something that is harmfull for it. Our bodies have a right over us. We must take care of ourselves.
    Allah swt gave us this illness as a trial. He knows. He knows what our hearts are going through. He knows what loss we feel when we look at others fasting and Thinkng of the rewards they will get by their fasts. He knows the anguish, the sense of loss. But Allah swt loves those who are patient.
    Verse of Quran; in Allaha ma’assabereen. Allah swt is with those who are patient….
    Don’t feel bad.. It’s ok. Allah swt gave us this illness we didn’t chose it… So don’t blame yourself over something that is not in your hands…
    This is a month of blessing. Don’t let this month go by grieving. Make the best out of it. Do what your body allows you to do. Pray your fard, nafal, do lots of zikar, charity dua lots of dua. Dua it’s self is worship. Read Quran or listen to it. It gives peace.
    Even when in bed and you feel all low you cannnn do zikar and dua. Allah swt willll nottt let our efforts go waste my dear sister..
    Grief not. For Allah swt is near. He knows
    May Allah swt give us all health and a quick recovery. Ameen.
    As sister Abez said. We will met in Jannah my friend all healthy insha Allah. :)
    
    Jazak Allah khair urn kathera :)
    
    Reply
Leenah OV

June 30, 2014 at 5:31 PM

Assalamu Alykum. Thank you for this article: it is informative and thought provoking. On another note: I have been able to restore my health by a “paleo” diet for the past two years after suffering from a lot of pain, migraines, fatigue, mental fog, inflammation and IBS. Please consider the “Wahls” protocol for MS sufferers. A Jordanian sister with MS had also great results with it. Google MS paleo to find it. May Allah SWA grant you healing.

Reply
- Imraan
  
  July 1, 2014 at 9:03 AM
  
  Thank you for that tip! I’m going to have to try it myself – if I may ask it, were you an MS sufferer, too? The symptoms you describe are quite similar to mine, though I have a different neurological condition. Incidentally I just bought Dr Wahl’s book – I’m glad someone else has managed to attain better health through it, alhamdu lillah.
  
  Best wishes for this blessed Month.
  
  Reply
  - Leenah OV
    
    July 6, 2015 at 5:27 PM
    
    Assalamu Alykum
    Dear Imran,
    I apologise for this late reply, have had a year filled with travel and helping others because I am again physically and mentally able to and have the necessary energy. I did not have MS but I was probably heading down that road. Real food, trying to find more relaxation and positive soothing reflections through our religion have made that possible again. I hope you feel better now!
    
    Reply
Hyde

June 30, 2014 at 7:05 PM

Bless. Very timely article.

Reply
Holly

June 30, 2014 at 11:57 PM

Dear Sister, thank you so much for writing this. I am a new Muslim and this is my first Ramadan. It has been a great struggle balancing feelings of spiritual failure against my physical health (and medication). I continually go back to 2:185 for solace, and I am only taking in what is absolutely necessary. Moreover, I choose carefully what I eat, as I’m truly trying to cleanse my body and spirit. I’ve also made a donation to our local hunger program. I pray that Allah accepts my intention. But thank you again for letting me know that I am not alone in this experience. Thank you for sharing your story, and I pray that you have a blessed Ramadan.

Reply
- Zenab
  
  July 1, 2014 at 10:29 AM
  
  Salaam, my name is zenab “and I am the founder of the disabled Muslims network, the dmn is an organzation that supports Muslims with chronic illnesses and disabilities living worldwide. Feel free to message me via http://www.facebook.com/disabledmuslimsnetwork
  
  Reply
Amel

July 1, 2014 at 5:00 AM

As-salamu Alaykum,
This is an important article and reminder. Two people in my family are unable to fast due to chronic health conditions that require medications at set times. In both cases, the conditions were diagnosed unexpectedly, which made each person feel like they were suddenly robbed of the opportunity to fast. It is kind of like suddenly being hit by a car and wondering what just happened. Both people are young, and I have seen with these individuals that it is a terrible feeling to suddenly find that you are unable to fast, and to know that you may never again be able to fast. This is why we should heed the advice of the Prophet (PBUH), which says:

“Take benefit of five before five: Your youth before your old age, your health before your sickness, your wealth before your poverty, your free time before you are preoccupied, and your life before your death.”

There is also a stigma associated with not fasting, which may lead people with illnesses to pretend they are fasting in social situations. No matter how ill you are, there will always be people who doubt that you are truly ill enough to break your fast, and they may make non-fasters feel guilty, especially if they are young. This even happens with pregnant women, who are sometimes chastised by other women who feel that it shows weakness to break one’s fast during pregnancy. When the non-faster is male, however, the stigma is even greater, because no one expects to see a young (supposedly healthy) male breaking his fast. Keeping this in mind, I hope we all check our attitudes towards non-fasters because things are not always as they appear on the outside, and the non-faster may be suffering intense turmoil during this blessed month.

As for people who are not fasting, Ramadan this year is taking place during the summer, which means that the weather is hot, and the days are long. A lot of Muslims are fasting, but they do not have much energy or stamina. People who are not fasting (for legitimate reasons) thus have some advantages over fasters in that they can (in some cases) more easily move about and exert themselves (provided they are not too ill). If someone is unable to fast (whether ill, pregnant, menstruating, etc.), this is but one aspect of Ramadan, and there are many other beneficial things one can do during the month, which is a month of enormous and unparalleled blessings. Each person should try to determine for him or herself which types of good deeds they are capable of and then try to do them. It could be anything, small or big. Even if you are confined to bed, you can try to think of something beneficial to do, whether it is with your money (if you have the means) or your mind. Even the simplest act (such as bringing a smile to the face of another human being) can have a positive impact.

Reply
Imraan

July 1, 2014 at 9:18 AM

Dear sister, thank you for this reassuring piece. I’ve been living with a chronic health condition for over seven years now, and been very unwell for the last three and a half; every year I go through the grieving process for not being able to fast because I’m on a cocktail of medication and dozens of supplements just to help keep me going for the rest of the year, let alone the Noble Month.

For too-long has there been a stigma surrounding ill-health among Muslims, because people – though well-intentioned – seem to want to find a ’cause’ for the condition with the hope of treatment taking form in Du’a or exorcism, or increasing worship, or whatever else. Maybe it’s a cultural thing largely, in that we forget that these tribulations we face are tests of our character from the Almighty – largely, finding advice on the developing and beautifying of the soul and spirit of the unwell person seems lacking when scholars address congregations. I can’t blame them, of course, because those who often might require this kind of counsel or advice tend to be lacking from such congregations regularly, or haven’t a voice sufficient to be heard; whereas we do so-much for the plight of the unwell, the orphans, widows etc. in the heartlands of the Muslims, I hope in sha Allah that our communities can perhaps, in addition to this as awareness increases, offer a different kind of support to those that need it locally.

In sha Allah, I pray that He grants you and all others healing and that you find what works for your health; in the meantime there are millions of us unable to fast due to long-term ill-health who have to live with the burden of trying to justify to others, and then ultimately ourselves, why we cannot fast. Of course, it is good to be certain that this is obviously detrimental to one’s health, because after all we can only deceive ourselves, never Him; yet once we’re past that stage there is an obvious void in terms of the support available to the chronically unwell to prepare for the Noble Month, advice that we can take in order to benefit as much as possible from the bounties of this most precious of times.

Thank you for this, once more.

With love and prayers,

Reply
- Zenab
  
  July 1, 2014 at 10:30 AM
  
  Salaam, my name is zenab “and I am the founder of the disabled Muslims network, the dmn is an organzation that supports Muslims with chronic illnesses and disabilities living worldwide. Feel free to message me via http://www.facebook.com/disabledmuslimsnetwork
  
  Reply
nadia

July 1, 2014 at 2:37 PM

Excellent article. Love the last point about it being and act of obedience by not doing harm. I also love this “When a slave of Allah falls ill or goes on a journey, he is credited with the same amount of recompense as he used to do in his state of health or when he was at home” Al-Bukhari 2996

Reply
Abez

July 2, 2014 at 2:03 AM

JazakillahuKheiran! You hit the nail on the head, sister- especially the part about mourning the loss of your ability to fast. I have POTS, Ehlers-Danlos Syndrome, and Sjogren’s Syndrome, and I wasn’t able to fast at all last Ramadan, and I think the one before it too.

Ramadan stopped being… “special” and just became a time of sulking and grief. SubhanAllah, it took me a while to get my head on straight and this Ramadan I’m trying to hit up other acts of worship and be grateful that I can eat and drink rather than just mope.

<<<>>> from your sister in Islam as well as chronic illness. May we meet in Jannah perfectly healthy and perfectly content. Ameen.

Reply
- Abez
  
  July 2, 2014 at 2:05 AM
  
  There were supposed to be extra gentle hugs in those brackets, and I’m not sure why they disappeared from the comment. So I’m putting them here- with extra, extra gentle hugs.
  
  Reply
  - Maryam
    
    July 10, 2014 at 10:40 PM
    
    Sr Abez, have you seen the documentary Sick, Fat and Nearly Dead? Sometimes fruits and vegetable juicing exclusively helps alleviate pain a great deal.
    
    Reply
  - Anna
    
    June 29, 2015 at 3:01 PM
    
    ASA, Sister,
    I know you left this comment last Ramadan but I was just blown over that another sister has EDS!! I have been grappling with whether or not I should fast this year as the first year I did it (2013, I’m a convert), I didn’t mind the hunger but my blood pressure dropped constantly and I fainted at work a few times. I’ve been trying to find some guidance as to whether I should just do it anyway or whether this makes me exempt. Any resources you have found would be appreciated!
    Jazaakallahkhair
    
    Reply
- Missi
  
  July 13, 2015 at 1:20 AM
  
  I know exactly how you feel. I also have EDS and POTS. Lots of hugs to you!!
  
  Reply
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Rebecca

June 17, 2015 at 4:06 PM

Thank you for reposting this from last year. I have a few chronic illnesses. Nice to see so many who feel the loss of what we once could do. I fill my “fasting” by offerring to feed sisters, help with the kids so they can go to events, rides. Support in general. Our group even set up a FB page to coordinate it all. I’m involved and helping others to get the most from Ramadan and fasting. I am able to say this has all been a huge help for me and others.

Reply
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Missi

July 3, 2015 at 7:45 PM

This was so touching. I’m fasting during my first ever Ramadan, and it’s been such a struggle since I have Ehlers Danlos Syndrome and Postural Orthostatic Tachycardia Syndrome. I walk this fine line where I am able to fast for now but only with taking major sacrifices; I can’t go to the mosque in the evenings because of my fatigue, and I’ve felt so cut off from the Muslim community. There’s also this lingering knowledge that I will most likely not be able to fast in the near future, as my disorders are degenerative. It’s just helpful to know that I’m not alone and that others are facing the same circumstances. Thank you so much for this article; it’s what I needed at this exact moment.

Reply
UmmIskander

June 7, 2016 at 2:36 PM

Salaams I am so glad to read this, I am a parent carer to my disabled child and we live alone. I have been exempted from fasting because of my caring, my daughters disability and my own health issues ( I have to be with it 24/7 for my daughter). This is so rarely talked about. I had it explained to me that fasting should not be about neglecting your family or not being able to care or potentialy putting a child in danger or making your self ill.

Reply
Umm Bilal

June 17, 2016 at 1:01 PM

Thank you so much for sharing your article. I have severe health problems that causes me not to fast. After reading your article it makes it easier.

Reply
UmmSusu

June 16, 2017 at 12:16 AM

Assalaamu ‘alaikum!

I too suffer from MS and have not been able to fast since 2012 after my last pregnancy. I also feel depressed and I wonder if it is from illness itself since it effects the brain. May Allah heal us all, make this a purification, and accept our deeds and make us sincere. Ameen!

Reply