Spirituality and Depression: A
Century-Long Research Review
|
A recent
USA Today cover story titled "Kids and
Depression"highlighted the alarming rates of depression
among children and noted that suicide rates among this
group have tripled since the early 1960s. Now, more than
half a million U.S. children take anti-depressants.
"Children donąt have the anchors, the emotional support
they used to have in growing up," noted Dr. Frederick
Goodwin, a George Washington University psychiatry
professor and past director of the National Institute of
Mental Health. He cited high divorce rates that fracture
families as well as moves averaging every seven years,
three times as frequent as in the 1960s. |
Questions raised
• In addition to prevention, does religious
participation also help in recovery from depression if
it strikes? For example, the teen featured in USA
Today who recovered from major depression became
active in a church youth group and was shown in a photo
serving communion in a special Mass for teens. (see
Preventing Depression article below)
•Does "religion from the heart" versus "religion
for show" make a difference in risk for depression?
Data finds "religion for show" may
increase risk. (see
A Look at "Intrinsic" vs. "Extrinsic"Motivation
article below) |
Preventing Depression
A new
broad review of more than 80 studies appearing over the last 100
years found a factor steadily linked with lower rates of
depression: Persons who participate in a religious group and
highly value their religious faith "are at a substantially
reduced risk of depressive disorder" 1
while people with no religious link may raise their risk of
experiencing depression by as much as 60 percent.
2
"Lack of
organizational religious involvement leads to a 20-60 percent
increase in the odds of experiencing a major depressive
episode," noted Michael McCullough, Ph.D., and David Larson,
M.D., M.S.P.H., of the National Institute for Healthcare
Research who undertook this 1999 review.
Why might
a spiritual link help prevent depression?
"Valuing
one's spirituality as centrally important and actively belonging
to a religious group may give spiritual roots that provide
meaning as well as support from others. This creates anchors of
hope and caring which might help protect against depression,"
Dr. Larson commented.
1. USA
Today, Nov. 30, 1999, A1-2 and 8D.
2.
McCullough M.E., Larson D.B. "Religion and depression: a review
of the literature." Twin Research 1999; 2: 126-136.
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Prozac Plus Prayer - a Two-Pronged Prescription
Does
adding religious content - like prayer and meditating on
scripture - to therapy for depressed religious patients
help recovery? One study comparing treatment with or
without religious content found Christian religious
patients recovered faster with it.1
Another study of Muslims with anxiety disorder found
adding prayer and readings of the Koran to therapy
resulted in more rapid improvement. 2
Two research psychiatrists from Duke University Medical
Center comment:
"In our study of older medical inpatients we found that
the cognitive symptoms of depression (hopelessness,
depressed mood, and so forth) were particularly less
prevalent among those who depended on religious belief
and activity in coping, whereas the more biological or
somatic symptoms of depression (weight loss, fatigue,
insomnia, and so forth) were unrelated to religious
coping. This suggests that religious treatments are
primarily beneficial for patients with milder forms of
depression and that severe depression requires
specialized psychiatric treatment and antidepressant
therapy."
"Combination treatment that addresses psychological
issues and conflicts (the mind), religious concerns (the
spirit) and biological causes for mental illness (the
body), may indeed harbor the potential for best results,
although little scientific research has tested such
hypotheses." 3
1.
Propst L.R., Ostrom R., Watkins P., Dean T., Mashburn D.
"Religious values in psychotherapy and mental health:
Empirical findings and issues." Journal of Consulting
and Clinical Psychology 1992; 60: 94-103.
2.
Azhar M.Z., Varma S.L., Dharap A.S. "Religious
psychotherapy in anxiety disorder patients." Acta
Psychiatrica Scandinavica 1994; 90: 1-3.
3.
Dr. Harold Koenig and Dr. David Larson in "Spirituality
and Religion in Recovery from Mental Illness." New
Directions for Mental Health Services 1998; 80:
81-95 |
Risk of Depression Rises Among the "More-for-Show" Religious
-- A Look at "Intrinsic" vs. "Extrinsic" Motivation
|
If a
person's religious commitment is self-oriented and "more
for show," will it protect them from depression or does
it lead to more down feelings?
People whose religious motivation centers on obtaining
self-justification, social advantages or personal
security - known as "extrinsic" religious faith - showed
more symptoms of depression in the 100-year review of
studies addressing depression and religious commitment.
Dr. Gordon Allport, Harvard psychologist, first
distinguished between intrinsic and extrinsic forms of
religious commitment in 1967. He described that the
extrinsically religious person uses religion as a means
of obtaining status or personal security, for
self-justification and for sociability, thus making
religion more utilitarian and self-oriented. In
contrast, the intrinsically religious person
internalizes beliefs and lives by them regardless of
outside or extrinsic social pressure or other possible
personal consequences.
He, along with several other researchers, developed
scales using a number of questions to measure intrinsic
and extrinsic motivation.
In
the studies using these scales, extrinsic motivation was
linked with more depressive symptoms. However, intrinsic
motivation was linked with less depression. |
Intrinsic religious motivation also appears to protect
people from depression who face high stress, such as
serious illness, the research review showed.
"Medically ill adults with high degrees of intrinsic
religiousness are slightly less likely to be diagnosed
with major depression," commented review authors Michael
McCullough, Ph.D., and David Larson, M.D., M.S.P.H., of
the National Institute of Healthcare Research. "
A
comprehensive study with a one-year follow-up found that
people who indicated that 'a strong religious faith' was
among the three most important things in life had only
38 percent chance of becoming depressed in comparison
with those who did not ascribe such importance to their
religious faith," Dr. McCullough and Dr. Larson noted.
Also, among those who were depressed at the beginning of
the study, those who ranked their religious faith as
highly important recovered faster.
"People who indicated that having a strong religious
faith was one of the most important things in life had
only 17 percent chance of remaining depressed at the
one-year follow up," the researchers commented.
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References:
McCullough
M.E., Larson D.B. "Religion and depression: a review of the
literature." Twin Research 1999; 2: 126-136.
Azhar M.Z.,
Varma S.L., Dharap A.S. "Religious psychotherapy in anxiety
disorder patients." Acta Psychiatrica Scandinavica 1994;
90: 1-3.
Bouncing Back from Depression when Physical Illness Strikes
Depression
often strikes patients hospitalized for medical illness. While
major depression afflicts only 1 percent of older adults living
in the community, 45 percent of the hospitalized medically ill
elderly may suffer with mild to severe depression. Besides
impairing quality of life, depression appears to delay recovery
from physical illness, lengthen hospital stays, and increase
risk of death. Can religious commitment make a difference?
Former
president of the American Psychological Association Martin
Seligman, Ph.D., stated that ways religion and spirituality
might decrease depression is by fostering positive beliefs and
behaviors while lessening the impact of negative circumstances.
Three
research studies reviewed below found religious commitment
enhanced recovery from depression.
A
year-long study of 87 depressed older adults hospitalized with
medical illness found that the greater extent a patient's
religious faith was a central motivating force in their lives,
the faster they recovered from depression.
For every
10-point increase in their intrinsic religiosity score, which
ranged from 10 to 50, there was a 70 percent increase in speed
of remission. This effect remained after controlling for
multiple demographic, psychosocial, physical health and
treatment factors.
"Religious
beliefs and behaviors are commonly used by depressed older
adults to cope with medical problems and may lead to faster
resolution of some types of depression," according to a study in
the American Journal of Psychiatry. "Psychiatrists should
feel free to inquire about and support the healthy religious
beliefs and activities of older patients with disabling physical
health problems, realizing that these beliefs may bring comfort
and facilitate coping." 1
In another
study of 850 elderly men admitted to the hospital for acute
illness, researchers found that patients who used their
religious faith to cope were significantly less depressed. In a
subgroup of 201 patients, the extent of their religious coping
predicted lower depression scores six months later. Furthermore,
the clinical effects were strongest among those with severe
disability. 2
A study of
women recovering from hip fractures found that those to whom God
was a strong source of strength and comfort and who frequently
attended religious services were less depressed and could walk
further at discharge then patients who lacked a strong
religious/spiritual commitment. The significance of their faith
lowered their risk of depressive symptoms and aided them in
better handling a stressful medical event. 3
1 Koenig
H.G., George L.K., Peterson B.L. "Religiosity and remission of
depression in medically ill older patients." American Journal
of Psychiatry 1998; 155(4): 536-542.
2 Koenig
H.G., Cohen H.J., Blazer D.G., Pieper C., Meador K.G., Shelp F.,
Goli V., DiPasquale, R . "Religious coping and depression in the
elderly hospitalized medically ill men." American Journal of
Psychiatry 1992; 149(1): 693-700.
3 Pressman
P., Lyons J.S., Larson D.B., Strain, J.J. "Religious belief,
depression, and ambulation status in elderly women with broken
hips." American Journal of Psychiatry 1990; 147(6):
758-760.
