Does Religion Cause Depression?

Based on a joint study conducted by the Harvard School of Public Health and the World Health Organization in 1990, depression was identified as the leading cause of disability in the world (measured by years of life lived with disability) and in 2020 is expected to be the world’s second leading cause of disability, surpassed only by cardiovascular disease.  The likelihood of experiencing depression during one’s lifetime is 20% in American women and 10% in men.  This means that 20% of men and 10% of women at some point during their lives will experience a depression.

Depression is a lot different than the daily mood swings that we all face when dealing with minor losses or disappointments.  The depression I’m referring to interferes with a person’s ability to function either at work, in social relationships or recreational activities, and this continues for weeks or months without relief.  Depression, while heavily influenced by genetic factors and heredity, often results from a failure to cope with difficult life circumstances.  While 7% of people in the United States currently suffer from depression, this figure increases to 10% to 45% in people with chronic medical illness, depending on how severely disabled they are and serious the medical illness is.  Depression itself is a life-threatening illness that interferes with recovery from medical illness and actually interferes with the body’s natural healing systems (immune, endocrine, and cardiovascular functions).  In addition, about 15% of people with depression end up committing suicide rather than face month after month of unbearable suffering.

What is the relationship between religious involvement and depression?  In an earlier column I discussed the role of religion in coping with loss, trauma, and disability.  But, does turning to religion result in better coping and protection from depression or result in faster recovery from depression?  This is a question that I’ve been studying for almost 25 years, especially among those with chronic medical problems and disabling illnesses that truly challenge a person’s coping abilities.  We have studied almost 2,000 hospitalized medical patients, measuring their religious involvement, their coping ability, and their level of depression.  Every one of these studies found that religious involvement was related to lower rates of depression or faster recovery from depression.

Our research group is not the only one to report such findings.  In our systematic review of research conducted between 1872 and 2010, we identified 444 studies that quantitatively examined relationships between religious involvement and depression.  Of those objective scientific studies, 272 (61%) found that those who were more religious experienced less depression, recovered faster from depression, or experienced a reduction in depression severity in response to a religious or spiritual intervention.  In contrast, only 6% reported greater depression in those who were more religious.  Of the 178 best-designed and most rigorous studies, 119 (67%) found inverse relationships between religious involvement and depression.

Religion provides hope and meaning in the most difficult of life circumstances.

This does not mean that deeply religious persons never suffer from depression or get better more quickly than others.  It only means that everything else being equal (which it seldom is), those with a strong religious faith who are participating in a religious community have more coping resources at their disposal to help fight depression.  I have found that some of the most religious and spiritual individuals have often experienced problems with depression, and it is precisely the suffering that they went through that caused them to turn to religion and deepen their relationship with God.  Some of the greatest religious leaders in history suffered from terrible depressions, including Job, Elijah, Jeremiah, and probably King David, and in more recent times, Martin Luther, Charles Spurgeon, and many, many others.  Therefore, one cannot conclude that just because someone is depressed that they don’t have enough faith, aren’t praying or not going to church enough.  There are many, many causes for depression – genetic, childhood experiences, accidents, and simply bad luck — which people are not responsible for (just like there are many causes for diabetes, high blood pressure, cancer, and other physical illnesses).  Depression is a very complex psychological, social, and biological illness, and the only one who knows all of the circumstances that lead up to it is God himself.  Thus, there is no room for guilt or condemnation from others or from oneself, since no human being has all the facts at their disposal to make a fair judgment.

Thus, if you know a family or friend who is having a hard time with depression, don’t add on to their burden of suffering by telling them if they were just more religious then things would be different.  Instead, show them support and loving kindness, and treat them as you would want to be treated if you had this dreadful disease (which only by the grace of God you don’t).  Yes, faith can make a huge difference, but sometimes it’s the faith of loved ones that needs to suffice when the person with depression is having trouble with their own.  Listen to and pray for that loved one.  Be available to them if they need your assistance.   Don’t offer them advice or counsel, unless they ask for it, or you may run the risk of getting yourself in a situation like Job’s counselors did when they tried to explain and fix Job’s problems, which resulted in their being rebuked by God.  It was only after Job prayed for their forgiveness that God let them off the hook.   So, avoid advising or correcting, and focus instead on listening, loving, and trying to understand the immense burden they are carrying.

If the depression seems so severe that it has paralyzed the person or may be endangering their safety by increasing risk of suicide, then by all and any means get them to see a doctor.  For severe depressions like this, faith is seldom enough.  It requires both faith and medical treatment.  In a research study we did a few years back we found that when depression started to interfere with people’s sleep, their concentration, or their ability to maintain their weight (loss of appetite), then it didn’t matter how devoutly religious the person was.  What they needed was medical treatment.  Once stabilized with medical treatment, however, religious involvement often helped prevent depression from recurring.  In my next column, I will discuss a new religious psychotherapy study for treating depression in North Carolina and Southern California.


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Harold G. Koenig, MD, MHSc., completed his undergraduate education at Stanford University, his medical school training at the University of California at San Francisco, and his geriatric medicine, psychiatry, and biostatistics training at Duke University Medical Center. He is board certified in general psychiatry, geriatric psychiatry and geriatric medicine, and is on the faculty at Duke as Professor of Psychiatry and Behavioral Sciences, and Associate Professor of Medicine, and is on the faculty at King Abdulaziz University, Jeddah, Saudi Arabia, as a Distinguished Adjunct Professor. He is also a registered nurse. Dr. Koenig is Director of the Center for Spirituality, Theology and Health at Duke University Medical Center, and is considered by biomedical scientists as one of the world's top experts on religion and health.

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