Does Guru Granth Sahib describe depression?

Sikhism is a relatively young religion, with Guru Granth Sahib as its key religious text. This text describes emotions in everyday life, such as happiness, sadness, anger, hatred, and also more serious mental health issues such as depression and psychosis. There are references to the causation of these emotional disturbances and also ways to get out of them. We studied both the Gurumukhi version and the English translation of the Guru Granth Sahib to understand what it had to say about depression, its henomenology, and religious prescriptions for recovery. We discuss these descriptions in this paper and understand its meaning within the context of clinical depression. Such knowledge is important as explicit descriptions about depression and sadness can help encourage culturally appropriate assessment and treatment, as well as promote public health through education.

INTRODUCTION

Sikhism is the youngest of all major religions dating from the 15th century AD. The followers of this religion are scattered around the globe. This religion does not allow idol worship, but the Holy Book or the Guru Granth Sahib is the guide for leading a pious and good life. The teachings of all the 10 Gurus are included in this book, along with those of other poets and religious leaders from Hindu, Sufi, and Islamic traditions. The religion, like other religions, has its own rituals and taboos, myths, and fundamental values. Any interpretations of the religion must take into account these cultural, social, and political contexts in which the religion emerged and subsequently developed. In this paper, we attempt to explore the concepts of modern depression in the Guru Granth Sahib and try and develop some therapeutic strategies that followers of Sikhism may find helpful. Such techniques have value both in clinical settings to improve assessment and treatment, as well as promote public health through education and tackling stigma.

SIKHISM: A SHORT HISTORICAL INTRODUCTION

Sikhism developed around about 15th century AD and found its origin in the teachings of Guru Nanak, the first of Sikh Gurus, and his nine successors.[1] The Sikh faith thus emerges over a few hundred years from the teachings of the 10 Gurus. The Shri Guru Granth Sahib (Granth- book; Sahib- Supreme) is revered by followers as the final Guru of Sikhism. The tenth Guru felt that the teachings included in the Granth Sahib should act as a guide in which the teachings of all the Gurus were embodied, and therefore announced that after his death the only Guru will be Guru Granth Sahib.[1] Followers of this religion are known as Sikhs which means a disciple, the one who follows the teachings of a teacher and learns from it.

The Guru Granth Sahib is a lengthy religious text comprising 1430 pages, compiled and composed by the Sikh Gurus from 1469 to 1708.[2] It consists of 19 lines of text per page, with a total of 26,852 lines. The text was first assembled by the fifth Sikh Guru, Guru Arjan Dev, from the hymns of the first five Sikh Gurus. Inevitably as the last Guru, this holy book is given the most important place in the Sikh religion. It is used in all Sikh worships and major functions like weddings and naming of babies. It is never left unattended and is usually covered with special colorful clothes.[3]

SIKH BELIEFS

Throughout the text of Guru Granth Sahib, various beliefs which shape the Sikh religion are mentioned with primary importance given to the Lord at all points. The scripture tends to have a central theme running throughout wherein man is considered a being of lesser importance, while the Lord is referred to as the Almighty and all powerful. A variety of qualities of the Lord have been described at various points [Table 1]. The Lord is also described as having countless (asankh) names (877-6; p. 1319) some of which have been enlisted in Table 2.

Table 1

Qualities of Lord

Table 2

Names of Lord

As per Sikh beliefs, everything that happens in one's life is as per the will (hukam) of God. The text emphasizes that rebirths are real and that there are approximately 8.4 million different forms of life. Every being has to go through these forms as reincarnations (p. 27, p. 50), which include that of worms, insects, elephants, fishes, deer, birds, snakes, rocks, mountains, etc. (p. 176). Human life has been mentioned as the last incarnation (631-16) that one gets only after good karma. All incarnations are said to have pain and suffering at their core, except the human life which is said to be the best of all, giving one the opportunity to meet the Lord (631-16). It is only in human life that one can get peace by reciting the name (Naam) of Lord (207-9). If one recognizes the true Lord, then he is never reincarnated again and is released from the cycle of rebirths (434-4). The Sikh beliefs also rely on the importance of the thoughts that one focuses on during death, as these then determine the type of reincarnation that the individual will have [Table 3].

Table 3

Types of contemplation during death and its relation to reincarnation (p. 526)

Another important belief in Sikh religion is about one's karma. Karma refers to one's actions in life; the consequences of these actions decide whether a soul can be set free from the cycle of rebirths. Freedom from this cycle of rebirths is a type of emancipation called mukti. Various factors such as pride (hankar), lust (kaam), anger (krodh), greed (lobh), and being too attached to the world (moh) can stop a soul from attaining mukti. Guru Granth Sahib refers to the physical body as a robe that is influenced by one's karma (2-5). On similar lines, Hindu philosophy also views life along a continuum and equates rebirths to the changing of clothes.[4] Caraka, a significant contributor to the science of Ayurveda, also gave importance to karma by describing the human body as an aggregate of cells that multiply by division under the influence of Karma, Vayu (the air, equated with bio-energy), and Swabhava (personal nature).[4] Thus, the importance of both approaches is that illness should be seen in a systematic manner where diet, environment, and other factors also affect the individual, the illness, and response to illness.

The text describes characteristics of two types of individuals: muhnmukhs (self-willed, and those who always think of themselves) and gurmukhs (those who always think of the Lord) (see Kalra et al. for a description).[5] The muhnmukhs are described as suffering in pain forever (29-11), wandering around “demented” (60-16) like the deer who wanders around searching for its own musk-scent (kasturi) (p. 644); the gurmukhs, on the other hand, are described as wondrously joyful (21-12) and attuned to the name of the Lord (29-11). The gurmukhs find the treasure of excellence with the Lord abiding in their minds (21-18). It is mentioned that mere self-discipline, meditative chants, or daily rituals are of no use if they are done without the Lord's name, which is usually done by muhnmukhs (p. 216), who thereafter die in frustration (27-17) and have been compared to worms in manure (28-9). The muhnmukhs are superficial beings, who perform religious rituals like an unwanted bride decorating her body, but her husband Lord does not come to her bed; day after day, she grows more and more miserable (p31). However, the gurmukh is referred to as a bride with a pure soul (p31). It has also been mentioned that gurmukhs win the battle of life, whereas muhnmukhs lose it (310-11) which may refer to the predisposition of muhnmukhs to emotional breakdowns or depression.

DEPRESSION IN GURU GRANTH SAHIB

We studied both the Gurumukhi version and the English translation of the Guru Granth Sahib[6] to see descriptions of depression within the text. Both the versions were read by all the authors and contemporaneous notes were taken on descriptions of depression in the scripture. These notes were then pooled together. The Sikh holy scripture explicitly discusses sadness and depression (dukh) using many metaphors (see Kalra et al. for a detailed discussion).[5] Although dukh may refer to physical pain and not depression per se, it can be argued that the mind cannot suffer from physical pain, and hence dukh here refers to depression. Here, we elaborate on the phenomenology of depression as understood in modern terminology that has been described in the Guru Granth Sahib.

Etiological references

Although many etiological references to depression are included in the scripture, the most important cause mentioned is when one forgets the Lord and implicit in warning that this is the duty to the Lord. These Verses warn that an individual's mind can be afflicted with terrible diseases (21-14) like depression (dukh) (59-12; 813-9) if one forgets the beloved (Lord) even for a moment. However, when one remembers God, happiness (sukh) automatically comes to that person (813-9). Ketiya dookh bhookh sad maar, ih bhi daat teri daatar (5-13) can be literally translated to the human being saying to the Lord that there is so much pain, hunger, and abuse in the world, but still these are like gifts of the Lord. This statement refers to people enduring distress, deprivation, and constant abuse, which have been considered gifts of Lord. This emphasis on dukh being a gift of Lord may be one of the factors why some people today still consider mental illness a curse of Lord and do not seek professional help on time.

The text goes to the extent of saying that those who do not take the name of the Lord suffer in agony even after death (36-8), while those who sing his praises stay in ecstasy forever (sadaa anand) (36-12). Guru Granth Sahib warns the devotee that one may enjoy carnal pleasures with hundreds and thousands of women, and rule the nine continents of the world, but without the true Guru, one will never find peace and mukti and will be reincarnated over and over again (p. 26).

Karma is the second etiologically important factor that leads to depression as per Guru Granth Sahib. Bad karmic actions force a person to sit and weep (15-11), while good karma makes them resistant to pain (dukh), disease (rog), and fear (bhau) (184-3,4), all of which are references to depression.[5]

Various other causative factors for depression have been discussed at various points in the text. Death of a person has been especially given some importance. The text mentions that death of a loved one may give rise to feelings of worthlessness in the survivor (83-15). It cites the example of a widow, who after losing her husband may suffer in sadness (226-2).

Other causes that have been listed are taunts (fika-bol) (15-14), hypocrisy (pakhand) (28-17), and loss of wealth (dhan) (p. 59-14). Drinking of wine results in madness (baral) (554-14) that is characterized by sadness, hopelessness (niraasa), pollution of the intellect, restlessness, and misery, and can lead to all sorts of diseases (rog) (p. 279 and 280). The text also mentions three factors that are bad for the body and mental peace (24-16; 19-11) and can cause depression: excessive and unfulfilled sexual desire (kaam), anger (krodha), and egotism or pride (ahankaar) (p51). These have been variously referred to as demons (paret) (513-13) and wounds of the soul (jeeah mei chot) (152-11).[5] The text also sums up by pointing toward a desire and love for materialistic things (love of maya) as the root cause of all diseases leading to dukh (909-2).

Symptoms

Symptoms of depression have been mentioned throughout the text. Depressed individuals are said to suffer in sadness and agony and have been compared to maggots in manure (bista meh keerey) (125-8). Like the deer caught in a trap (fahi fathey mirag), they continually cry out in pain (23-2). Reference to decreased interest in previously pleasurable activities (anhedonia) has been made on p. 179 of the text. It is said that one may not feel interested in his or her work like acting in dramas or singing in theaters, or riding horses or elephants. There is also a loss of interest in grooming oneself with jewelery and dressing in silk and satin clothes (p. 225), representing self-neglect. Bad karmic actions force a person to sit and weep (15-11). This reflects the psychomotor slowing and crying seen in depression. There are also references to loss of interest in sexual activity.

The text also mentions that the afflicted mind (muhn-bhulo) may harbor negative thoughts (vikar) (222-3). The negative outlook of the depressive is evident in line 1 of page 610 which states that the sick person perceives everyone else as sick, while to the happy person, everyone else seems happy, and also that for the depressed, colors may appear faded and washed away (27-19). Weeping (rona) (316-16) and loss of sleep (neend) and appetite have been mentioned as symptoms of sadness seen after the person is separated from the Lord (244-19), as is heaviness on the head (sir aavey bhaar) (222-3). The tongue is said to lose all tastes in the absence of the name of the Lord (354-16); all tastes (saad) are perceived as insipid and bland (fika) (218-15; 385-4). In the absence of the Lord, one becomes dukhi, so it can be interpreted that loss of taste is mentioned as a symptom of dukh. The afflicted person may also have poor self-care and may be dressed in filthy cloths (mailey veis). A reference to hopelessness as a symptom probably is reflected in the following line: In front of me, I see the jungle burning; behind me, I see green plants sprouting (20-4).

There are references to doubt (sansaiy) and skepticism (bharam), both being part of depression as these never affect the ones who are always in touch with the naam of God (250-17).

Therapeutic context

The text also illustrates therapeutic issues in depression at an individual level by asserting that peace and tranquility of the mind can restore the mind to its original balanced state or equipoise (sanatan). It gives due importance to diagnosing depression (p. 1279) and treating it in time. The text equates the Lord's name to medicine (aukhad) (259-14; 675-6), mentioning that it can help the depressed person and relieve him of his depression. However, the scripture is not a pharmacopeia, and so not surprisingly there is no mention of the role of medication in the text. At some points, medicines and remedies have been said to be nothing more than ashes (196-1).

It also suggests meditation as having a therapeutic effect, provided it is done with the Lord's name in the mind (2-8; 11-4;11-19; 18-7; 20-19). Through meditation and listening to the religious scholars and spiritual teachers, devotees are forever in bliss (3-2).

The text enumerates many ways of praying (pujaa, bhagti) the Lord, some of which include: Ardaas (prayer), shabadandkirtan (holy songs), naam-jaap (chanting the Name), oostuht (praise the Lord), listening to saakhi (Guru's teachings), gurbani (Guru's words), and upadeis (teachings). It notes that grief gets resolved by coming to the sanctuary of the parbrahma (sanctuary here may refer to any holy place) (132-19).

For a more long-term control and management of depression, the text recommends remembering (simran) and praising the Lord (p. 1421) and staying in his sanctuary (raam ki saran). Only these will lead to eternal peace (p. 1427) and balance within the mind (674-10).Chanting the name of the Lord (har-jap) and dedicating oneself to selfless service (sevaa) of others (110-1) enable the individual to attain happiness (21-10). The name can be chanted 24 h a day (aath pahar) (901-7) or day and night (896-18), and this serves as a protective and therapeutic measure for dukh (23-5). Thus, agurmukhi way of life has been recommended (21-10).

Apart from considering karma as etiologically important in depression, the Guru Granth Sahib also specifies that the Lord can forgive all beings for their bad karma in life. The only condition for this is that the person should surrender to the Lord (p. 106); these verses can be used in therapy with depressed clients who suffer from guilt for their bad karma. The Granth thus puts the locus of control totally on the outside, on Lord, on karma, on the universe, and in a way shuns people to take responsibility of their lives. This perhaps reinforces that an external locus of control is better.

As per the text, remembering Lord (Prabh simar) and meditation (dhyan) can free both the body and mind of any illness (611-11). Those who meditate on the Lord's name, with focused consciousness, remain stable forever (87-5). Raja Yoga, the Yoga of meditation, is said to give the perfect peace (sukh) and contentment (santokh) to an individual (p. 188). Samaadhi has been described as the final and ultimate end of a happy life, a sweet pleasure (106-15), wherein one merges imperceptibly into the Lord (90-18). However, an assertion is made that meditation should be done with the name of the Lord if it is to have any power. For example, meditation without the Lord's name was compared to an imaginary rider on a horse, or a eunuch caressing a woman, someone trying to milk an ox, someone riding a cow to chase a tiger, or someone going shopping without money (p. 198). Studies of prayer as treatment or preventive interventions for health problems are rare and often not published in scientific journals. For example, a study done in Amritsar on the regular recitors of Sukhmani Sahib showed a lower prevalence of hypertension in recitors versus non-recitors (4.76% vs. 9.7%).[7] However, such a research paradigm for religious texts may be unsuitable, after all religion offers meaning, hope, and belief for those suffering or uncertain about their future. There is a special place in Sikh (and perhaps all South and East Asian) teachings for dealing with pain and suffering. Guru Nanak distinguished many types of suffering: separation from God, the anguish of tyranny and death, affliction of bodily ailments, and the torment of mental and spiritual disease.[8] Indeed, Singh[8] argues that a special role played by religious teachings, sentiments, and experience is to offer a solution to the age-old dilemma of theodicy, namely, how can there be so much suffering in the world and why would God inflict this suffering if it was not to be endured. It is this form of remedy that may enable people to endure and deal with their suffering and pain, illness, and despair in a relationship with their God.

GURU–CHELA RELATIONSHIP

A Guru can cut out the sinful mistakes of sexual desire (kaam) and anger (krodh), fulfilling all hopes of the devotee (108-7). The text has given a special position to the Guru, who may be interpreted to play the role of a teacher or a therapist in the life of the dukhi, showing him the way to moksha or relieving him of dukh. Without the Guru, one loses his way and wanders around in the forest (57-3). The Guru has been equated to Lord (442-18) who resolves our affairs (kaaj sawaarey) (13-15) and to a ladder, a boat, and a raft carrying the victim across the “world-ocean,” which is probably the metaphor for melancholy. He is known to fulfill the hopes of the hopeless (p17), revealing the path to peace (60-9) and having the quality of empathy (soorat) (intuitive understanding; page 18-3). When one involves self in the service of the Guru, peace (61-5) and intuitive balance (sahaj; p. 68-5) is obtained.

Through the Guru's sermons (upadeis), pain and pleasure become alike (131-12), and joy (harakh) and sorrow (sog), feel the same to one's consciousness (214-13). The Guru's word has been equated with amrat (ambrosia) (185-5); suffering (dukh), agony (klesh), and fear (bhau) do not cling to those whose heart is filled with the Gurumantra (51-4). The mind, body, and soul, all are appeased (47-19). Those who suffer keep on wandering around the world begging, but get exhausted and find a solution only with the Guru in his teachings (p. 34). The solution is usually a jaap (chant), by which the name of the Lord and hence peace comes to dwell in the mind of the diseased (p. 34), leading to the state of moksha/mokha (salvation) (114-11). The Guru's word saves one from falling into hell (177-8), which may again refer to melancholy.

Renouncing (tiyaag) sexual desire, anger, and greed (408-19) to seek Nirvana (219-3) has been advised. Blaming (dose) others is of no benefit and one should instead blame his or her own karma which most often leads to all the suffering (433-14). The verse, Bin gur rog na tutai, haumai peerh na jaaei, makes a reference that the disease is not cured and the pain and egotism do not go away (36-3) without the Guru.

CONCLUSION

The Guru Granth Sahib is looked upon as a spiritual guide for Sikh individuals and is considered a living Guru after their tenth Guru. Although the book was written years ago, interestingly it has references to modern depression, including causes that can give rise to depression and symptoms that a depressive can experience. It also highlights and stresses upon therapeutic issues related to depression. Many of these points are applicable to depression in the modern context and can be useful in clinical scenarios. Mental health care workers and other therapists who deal with Sikh patients in distress can be in a better position to deal with them by understanding these descriptions within their religious text.