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How might the beliefs and practices of Hindus affect their mental health or influence the treatments that Hindus seek when they experience mental health problems?
Positive Effects on Mental Health
Mahatma Gandhi said: “I am a Hindu because it is Hinduism which make the world worth living. I am a Hindu hence I love not only human beings, but all living beings” (Gandhi, 1926). Niels Bohr, who helped discover the structure of the atom, said “I go into the Upanishads to ask questions” (Prothero, 2010). Julius Robert Oppenheimer (father of the atomic bomb) said “Access to the Vedas is the greatest privilege this century may claim over all previous centuries” (Oppenheimer, 1963). American essayist Ralph Waldo Emerson said: “I owed a magnificent day to the Bhagavad Gita. It ws as if an empire spoke to us, nothing small or unworthy, but large, serene, consistent, the voice of an old intelligence which in another age and climate had pondered and thus disposed of the same questions which exercise us” (Mishra, 1994).
Well-known and respected statesman, scientists, and authors, then, have inferred that Hinduism is related to good mental health, to better quality of life, and to stronger social relationships. Furthermore, there are numerous aspects of Hinduism that may link it to mental health, including on an emphasis on family and community life (for most castes), and integration of religious beliefs into all of life (Hindus often say that Hinduism is not a religion but a “way of life”), an ecumenical attitude towards other religions (Hinduism accepts other religions as valid pathways to God), and a belief that everything is connected (a pantheistic view of God, but also a view of God with personal characteristics whom humans can relate to).
Specific Hindu beliefs address the relief of emotional suffering, such as an emphasis on non-attachment to material possessions and dependence on the grace of God (Lord Krishna) to take away bad karma. Such beliefs, and the practices that reinforce them, are likely to foster good mental health, peace and well-being, and facilitate coping with trauma, loss and change. The emphasis on dharma as well, where the focus is on good actions, showing kindness to others, and behaving in heroic or brave ways to protect one’s family or community, could enhance social relationships and reduce stressful situations that result from self-centred greed and craving for material pleasures.
For example, the core teachings of the Bhagavad Gita focus on action in this world while at the same time emphasise avoidance of attachment to the results those actions that might cause suffering, anxiety, depression, discouragement, or otherwise adversely affect one’s ability to act effectively (3:7; 3:19). Likewise, the Gita addresses the fears and anxieties that surround dying by emphasising that death of the body is not the end:
“There never was a time when I was not, or you, or these rulers of men. Nor will there ever be a time when we shall cease to be, all of us hereafter… It [the eternal embodied self] is not born, it never dies; being, it will never again cease to be. It is unborn, invariable, eternal, primeval. It is not killed when the body is killed” (2:12, 2:20).
Thus, Hindus who abide by these teachings should (at least theoretically) experience less emotional distress in whatever circumstances they may face, and consequently have better mental health.
Negative Effects on Mental Health
But, might there be anything about the Hindu belief system that could promote neurosis, mental illness, or social conflict? For example, there are many different beliefs held by Hindus, which may not always be consistent. For some, the result may be confusion about what to believe, limiting their use in coping with stress (compared to religious traditions with more set, established, agreed on beliefs). Likewise, the Hindu notion of moksha (non-attachment to and withdrawal from the world) may foster disengagement from friends and family, resulting in social isolation and in negative consequences for mental health (given the role that social support plays in mental health and well-being). The caste system in Hinduism may also result in the exclusion or maltreatment of members of lower castes leading to discrimination, emotional distress, and alienation of certain groups in society, resulting in mental health problems among those affected.
Another liability to mental health may involve views towards women. Early Hindu beliefs concerning the treatment of women favoured the male in these ancient patriarchal societies (as in many other world religions), increasing the possibility of marital conflict or sexual coercion. For example, the Brhadaranyaka Upanishad says:
“When she has changed her clothes at the end of her menstrual period, therefore, one should approach that splendid woman and invite her to have sex. Should she refused to consent, he should bribe her. If she still refuses, he should beat her with a stick or with his fists and overpower her, saying: “I take away the splendour from you with my virility and splendour”” (6:4:6-7).
There is evidence that such demeaning views continue to influence the treatment of women within marriage in Hindu religion majority countries such as Nepal (Puri et al., 2011) and India, where domestic violence is reported by 40% of married women (Kalokhe et al., 2015).
These findings, however, contrast with the importance of family in Hinduism and Indian culture, where sexual relations outside of marriage are less common than in any other religious groups (except for Muslims) (Adamczyk & Hayes, 2012). According to the Taittiriya Samhita (part of the Yajurveda), fidelity between husband and wife is considered the highest dharma, and according to the Mahabharata epic poem, cherishing one’s wife is virtually synonymous with cherishing the goddess of prosperity (Sharma et al., 2013). However, in Indian society, there is considerable bias against women – particularly those with mental illness, who may be abandoned by their husbands and in-laws and sent back to the homes of their parents (Sharma et al., 2013).
There is also concern that Hindu beliefs regarding karma may influence attitudes in the Hindu community toward sick people, resulting in blaming of the sick person or their family members for the illness. In a qualitative study of 29 mothers of children and adolescents with severe intellectual disability, 17 community health workers, and 16 school teachers in Vellore, India, Edwardraj and colleagues (2010) reported that cultural and Hindu religious beliefs perpetuated negative attitudes toward disability. While there was considerable dependence on personal religious faith to cope with intellectually disabled children, there were complaints of lack of organised religious support. The findings revealed that “Society did not have a positive attitude towards the family with a disabled child. People avoided them and schools blamed the parents for the problem. This was possibly due to cultural and religious beliefs that disability was due to sin committed by the parents” (p 745). Similarly, in a qualitative study involving 47 mothers of intellectually disabled children and 29 teachers in urban India, John (2012) found that “when religion is used to positively reframe the child’s disability (e.g., blessing), it may be adaptive, but when it contributes to fatalistic or self-destructive beliefs (e.g., karma or punishment for past sins), it perhaps becomes maladaptive” (p 379).
A number of culture-bound syndromes in India appear to be related to Hindu religious beliefs as well. These include the Dhat syndrome (due to belief that a person needs to conserve his semen by remaining celibate if not married, and maintaining fidelity if married, which adds to his strength and brings him closer to Brahman), the possession syndrome or ghost illness (belief in possession by a religious deity or supernatural being), Bhang psychosis (also called “Indian Hemp Insanity” and due to cannabis intoxication), and Keemam dependence (addiction to indigenous product of India combined with betel leaves and lime, and chewed) (Akhtar, 1988; Freed & Freed, 1990; Prakash et al., 2014). There is also a culture-bound psychological reaction to pregnancy loss due to spontaneous abortions called Devaki syndrome (Nath et al., 2015). This involves identification with the religious figure Devaki, a Hindu queen who suffered multiple still births, but was rewarded with a child in the end (in the form of Lord Krishna). Women with this syndrome have depression and anxiety symptoms in the second trimester and become extremely preoccupied with child Krishna (and expectation of a male child). It is doubtful that Hindu beliefs are the cause of these relatively rare syndromes, which seldom occur in mentally healthy individuals.
Certain Hindu practices may also affect mental health adversely. For example, Hindu forms of intense meditation may in rare cases lead to depersonalisation, dissociation, or even psychosis in vulnerable individuals (Castillo, 1990; Waelde, 2004; Kuijpers et al., 2007). Meditation when practiced alone, ego-centred, and focused entirely on enhancing well-being (as Western forms of meditation often stress, while de-emphasising religious aspects) may lead to social isolation and excessive introversion. Finally, an unscrupulous charismatic Hindu teacher, sage, or prophet (guru) who is accountable only to self may manipulate others for self-gain, demand humble submission or even transfer of material assets as conditions of membership in the group (Crowley & Jenkinson, 2009).
Traditional Healing Practices
Sax (2014) has written about mental health and ritual healing practices in India, which are often based on social, cultural, and religious beliefs and practices. This may involve the sick individual visiting an oracle to determine the cause of the problem and then later the seeking of a healer. The “oracle” is a person who becomes possessed by local deities and answers questions during a trance-line state. Conditions that an oracle may be consulted on include lack of energy, insomnia, sexual problems or behavioural disturbances, fear or panic, or excessive family strife. The problem is usually identified as due to strife within the family, and so the family is often the subject of the ritual healing, not the individual. This is consistent with long-held beliefs by Indians concerning the person, family, caste, and society, with the family being central. Approximately 75-80% of Indians who seek psychiatric care in South Asia are simultaneously consulting ritual healers (Quack, 2012). Many people with mental health problems go to Hindu temples for these healing rituals. Rituals healers are typically well educated in Sanskrit, not science, and the majority of healers are low caste women or farmers.
In a study of 76 new outpatients attending a clinic in the department of psychiatry at a tertiary care hospital in Jaipur, north India, Jain and colleagues (2012) examined the route that patients usually take before finally arriving at the clinic. Family members of patients were interviewed. The majority of patients were young males from rural farming backgrounds who presented with psychotic illness. Out of the five different routes that patients followed, faith healers (40%) were the most common avenue through which they ended up being referred to the psychiatry clinic (followed by allopathic medical physicians at 29%). Mean duration of illness before being seen at the psychiatric clinic was 48.8 months (over 4 years). Although 39% sought faith healers directly, 17% went to see them after consulting psychiatrists.
Conclusions
Hindu beliefs and practices may have either positive or negative effects as illustrated in the examples above. While it is doubtful that pathological effects on mental health are common, they bear mentioning here for completeness sake. Many of the claims above – both positive and negative reports – are based on qualitative interviews, anecdotes or case reports. Therefore, it is time to examine what systematic quantitative research has found on the relationship between religiosity and mental health in Hindu populations (and on the mental health of Hindus compared with members of other religious groups).