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Jane Cooley FruehwirthAugust 19, 2019
A Mass for young adults on Dec. 7, 2016, at St. Patrick's Cathedral in New York City. (CNS photo/Gregory A. Shemitz)A Mass for young adults on Dec. 7, 2016, at St. Patrick's Cathedral in New York City. (CNS photo/Gregory A. Shemitz)

In 2016, nearly 45,000 people in the United States took their own lives, marking a 25 percent increase in suicide since 1999. Over roughly the same period, mental health expenditures in the United States more than doubled. In an especially alarming trend, the incidence of at least one major depressive episode per year among adolescents has risen by almost two-thirds over the past decade to reach 13.3 percent. Because many who experience mental health difficulties as adults first show symptoms during this developmental period, the World Health Organization lists mental health in adolescence as a top global health priority.

I have seen these trends in my own life as a professor. As a social scientist, I want to understand why. As a Christian, I wonder whether religion can help to protect adolescents from mental illness.

This has been a contentious question in the field of psychiatry. Sigmund Freud is known for his dire view of faith: “If one attempts to assign to religion its place in man’s evolution, it seems not so much to be a lasting acquisition, as a parallel to the neurosis which the civilized individual must pass through on his way from childhood to maturity.” But Carl Jung and other psychologists have taken a more positive view of the role of spirituality.

That positive effects of religiosity were strongest for the individuals presenting the most severe symptoms of depression, who are often hardest to treat.

What do statistics tell us? The preponderance of evidence supports the idea that increased religiosity is associated with better mental health. (Religiosity is measured through surveys of how often individuals attend religious services or pray, as well as how much importance they attach to religion.) But it could be that adolescents with better mental health attend church regularly and have a more stable home environment. How do we know whether it is the church attendance or the stable home environment that is benefiting them? This distinction is important: In one case the emphasis for improving mental health should be on religious involvement, and in the other, it should be on the home environment.

How could we show that religiosity has a causal effect on depression? If we could run an experiment to answer this question, we might randomly assign some adolescents to attend religious services or pray and others to avoid this activity; after a period of time, we could assess them for indicators of depression. But there are obvious ethical concerns in mandating religious attendance and otherwise convincing people to comply with the experiment. Instead, we can conduct what is called a quasi-experiment.

Students who by chance are exposed to religious peers become more religious themselves.

In collaboration with Sriya Iyer, an expert on the economics of religion at the University of Cambridge, and Anwen Zhang, an economist at the University of Glasgow, I investigated a unique data set, the National Longitudinal Survey of Adolescent to Adult Health, which includes rich questions on religiosity and depression, and we focused on the years when students were in high school.

We know that peers have strong effects in adolescence on a variety of behaviors, ranging from drug and alcohol use to academic performance. This is true for religiosity as well. When we look across grades in the same school, by chance students in some grades are exposed to more religious peers than students in other grades. This creates a sort of experiment. Students who by chance are exposed to religious peers become more religious themselves. We can isolate the effect of individual religiosity on depression using variation in individual religiosity coming solely from this random variation in the religiosity of school-grade peers. In other words, if certain adolescents become more religious as a result of exposure to religious peers, we can investigate whether these same adolescents subsequently show improved mental health.

By focusing our quasi-experiment on shifts in individual religiosity stemming solely from random exposure to peers, we are able to rule out that our estimated effects of religiosity are driven by individual background characteristics, like home environment or parental education. Because we are comparing students who are attending different grades in the same school, we can also rule out that the characteristics of the school are driving our estimated effects of religiosity.

Given that antidepressants show limited success, counselors who deal with children would be remiss to dismiss the potential beneficial effect of religiosity in treating clients.

So what do we find? Robust effects of religiosity on depression. For instance, among the students in our quasi-experiment, a 1.0 standard deviation increase in religiosity decreased the probability of being at risk of moderate to severe depression by 11 percent. (This standard deviation change in religiosity is fairly large; it is equivalent to switching from not attending church or church youth activities to attending at least once a week.) Perhaps most surprising was that these effects were strongest, almost two-thirds larger, for the individuals presenting the most severe symptoms of depression, who are often hardest to treat. This finding offers a startling contrast to evidence on the effectiveness of cognitive-based therapy, one of the most recommended forms of treatment, which is generally less effective for the most depressed individuals, at least in the short term.

Crucially, we found that the benefits of religiosity on depression are not driven merely by exposure to more religious peers in a school grade but instead by the individual student behavior. This is not to say that a more religious school environment is not helpful for the mental health of all (and this would be a great subject for future research). But all our comparisons were made across peer groups within schools to isolate the effect of individual religiosity. And we found that religiosity helps to buffer against some stressors, like worse physical health or the suicide of someone close. Furthermore, our research suggests that adolescents who have fewer support structures in place at home and in school experience more benefits from religiosity.

Interestingly, we see similar benefits of religiosity regardless of whether adolescents are active in other activities like school clubs or athletics. This suggests that these other youth activities, where adolescents can find a sense of meaning and social belonging, nevertheless do not appear to substitute for the benefits of religiosity on mental health.

Given that antidepressants show clinical success in reducing depression in only about one-fifth of cases, our research suggests that all counselors who deal with children would be remiss to dismiss the potential beneficial effect of religiosity in treating clients. With the growing body of evidence supporting a positive association between religion and mental health in many cases, research into religion is achieving growing acceptance in the field of psychiatry today, along with a variety of other fields, like economics. This is great news, as much remains to be discovered about how mental health and other important outcomes relate to faith and the inner spirit.

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Michael Bindner
4 years 10 months ago

Unless AA and NA attendance on one hand and suicides having to do with parental religiosity are included, the model is umderspecified and prone to type II error.

Alan Johnstone
4 years 10 months ago

What are you suggesting?
Counsellors should act as evangelists?

Gemma Cordingly
4 years 10 months ago

From my own personal experience, my faith has saved me time and again from the final step when pills and cognitive therapy have proven useless.

Trent Shannon
4 years 10 months ago

From my personal experience, finding faith, adopting prayer, has been a help with my treatment, but alone will make my problems worse - I was three days off my meds when "born again" and had a manic episode

Al Cannistraro
4 years 10 months ago

The author is an academic in the field of political economy. This article is based on a paper published in a journal of political economy, but it makes assertions that fall within the domain of psychology.

She presents her "scientific" findings here on a religious website.

Her assertions are about faith as psychological factors.

America seems to be endorsing those assertions, or at least promoting them.

I myself think those assertions would be more scientifically credible if published in a peer reviewed journal of psychology.

On the other hand, to me as a naive layperson, the author's assertions make sense and are in line with what I would expect.

But on the OTHER other hand, making the assertions here makes me suspect that the author is just shopping for a receptive audience.

Christopher Minch
4 years 10 months ago

Interesting article. Of course more research needs to be made on the subject and more variables need to be identified but this is what research does. Quit carping about its author and where she publishes and more about the actual subject matter and what else needs to be done to improve our understanding as to teen depression, escape through D+A and suicide and what can be done about this.

Randal Agostini
4 years 10 months ago

The headline is correct. It is not necessarily the "Religion" that matters, but whether it engenders Faith. There are many studies that are confirming that the goal posts that were erected through Religion were effective limitations to promote a healthy society, with limited exceptions. We can disappointingly but realistically say that we are now living outside an environment of faith. This is noticeable in our own Catholic Church where the vast majority no longer even believe in the most fundamental precepts. Statistics show that only 21% of those calling themselves Catholics - attend weekly Mass, of those less than half actually believe in Church Dogma and Doctrine and of those only about 7% are otherwise active in other church activity. This means that less than 1% of American Catholics are currently actively promoting their religion through Faith. But the article is about adolescents - people who now grow up in families that are more likely to have one parent in the home and that parent is more likely to be stressed out in trying to provide a safe environment for the child. In a sense we could say it is by the Grace of God that there is not more depression, or even suggest that society itself is committing suicide. Deep down we know that something is wrong, but we seem, like Don Quixote to be chasing after windmills. Let's pray.

Emily Linthicum
4 years 10 months ago

I am incredibly disappointed that America magazine would publish an article so harmful for readers. Yes, a person’s faith may be a part of their treatment, providing a sense of comfort and community. But, religiousity is not a substitute for scientifically proven medical treatment for depression, including CBT and medication as mentioned above. Multiple issues lie within this article, including the use of one “quasi-experiment” to argue these “results,” as well as publishing an article from an Economics professor rather than a mental health expert who is trained in treating these illnesses.
Based on my own personal experience, religiousity and practicing a faith has done more harm in my treatment of severe depression, as opposed to using practiced therapies and use of medication (which isn't a cure-all in of itself. More factors are involved in a person's life for why treatment may not work). Between people telling me that faith in God is the best way to overcome depression and trauma or condemning me for seeking psychiatric treatment, that something is spiritually wrong with me. I do realize these remarks are a result of people’s judgments rather than from God Himself. But, this is what I grew up with, what I was exposed to when I was seeking help. Even more so, there are even some people who use religion as the only solution, which results in adolescents not seeking help and that in turn has dangerous, life-risking results.
Religion should never be promoted as providing better results over types of mental health treatment, especially when priests or pastors are not social workers trained in this field. This is problematic for adults, let alone adolescents who are afraid to seek help.

Frances Robinson
4 years 10 months ago

I don't know why you're so angry. I agree with the author completely. I and my peers in HS were far less likely to be depressed because (1) we were religious (I went to Mass every day and still managed to be a very normal adolescent); and (2) we had Franciscan priests and brothers to talk to, even though we all went to public school (the only public HS in town that was located right next door to the only Catholic church in town). My sister wasn't as fortunate. She wasn't at all religious, and she was given one drug after the other, until she finally wound up a life-long drug addict, alcoholic and prostitute. In HS, my stepson was not at all religious, and he was depressed. But on 'medications' he went from being depressed to being very depressed and suicidal. My daughter wasn't at all religious, and after numerous med therapies, she killed herself at age 28. I KNOW that being religious saved me and my peers. So I don't have a problem at all with the author and/or this article. Oh, and one more thing, I vaguely remember a study done by The Pew Foundation? Practicing Catholics have a much less rate of mental illness and depression. I don't find that at all hard to believe.

Nora Bolcon
4 years 10 months ago

Frances, I am so sorry to hear about the death of your daughter. I too have suffered from depression. Some of it caused by my religion and its poor treatment of women and some of it relieved by good priests and fellow Catholics who reminded me it is my faith in Christ that matters and I don't have to agree with some of the teachings of this church as long as I follow Christ and his teachings in the Gospel. I find Holy Eucharist truly healing and prayer in community of mass and small prayer groups. These parts of our religion support my faith in Christian salvation and healing and inspire gratitude. I do definitely believe Christ heals mentally, physically, spiritually, and emotionally all who call upon his name. Hospital staff often recommend that religious or faithful people set aside time to meditate or pray during their hospital stay, as it has increased the physical health of so many patients.

Frances Robinson
4 years 10 months ago

Nora, I am really sorry about your depression. But what you said is not quite what I meant. I simply meant that those who are 'predisposed' (for lack of a better word at the moment) to being religious tend not to be so depressed, at all age. And, just for the record, I don't think that people who are 'religious' are better people than those who aren't. I simply think it's a mind/body thing that we are almost born with. A personality trait, more than anything else. And lastly -- and a tad humorously -- I spent years in therapy only to find out that my depression was caused by low Vit B12 and low Vit D. Once those levels were brought up to normal (took about 6 weeks), I wasn't all that depressed anymore. Anyway, my therapist used to say, "If we're not somewhat depressed and anxious in this world (meaning wars, politics, poverty, etc.), there really is something wrong with us." In other words, some depression and anxiety are very normal, considering the state of our society and the state of the world. We are the only country in the world that thinks we should be happy and that there is something wrong with us if we have some depression and anxiety -- and that's not realistic at all.

Emily Linthicum
4 years 10 months ago

I have every right to be angry. It sounds like you're the one that needs to do some introspecting of yourself and your ignorance based on personal examples in your life without looking beyond to other people's experiences. I was born and raised Catholic, went to Catholic schools all my life, and currently teaching Theology in a Catholic school (yes, I have two degrees in this). As a 10 year old child, I was told my sins were so unforgivable the even God wouldn't forgive me. Most of my depression and trauma results from those who were supposedly Catholic, including my parish's priest. So would you tell a young child looking for help it is their fault and all they should do is pray to God and not seek professional help? Would you blame them and say it is their fault they are struggling because they aren't being Catholic enough?
I'm happy that your faith and community helped you so much. And I am sorry about your daughter. But, maybe you should consider that not everyone is so lucky to have such an experience. I know many Catholics and other Christians, both in my personal life as well as professional, who are devout and good people and they also struggle with mental illness. So I actually find it more hard to believe your spin on the state of things above anything else. I hope you can gain some worldly and less judgmental perspective on experiences that differ from yours. Peace.

Frances Robinson
4 years 10 months ago

Your two degrees and teaching experience really don't lend any more credence to anything you say. You're just angry, and I think you are choosing to misunderstand the author and me. That isn't at all what the author and I are saying. It really has nothing to do with being Catholic. It has to do with having almost a personality predisposition to being religious, period. I don't see anywhere in the article where she says that all anyone, with depression, has to do is be very Catholic and pray, and they will somehow be magically healed. As for your experience as a 10-year-old child, I've never heard of such a thing from any person in my whole life, and I'm 70 years old. So your experience is rather unique, to say the least.

Emily Linthicum
4 years 10 months ago

Frances - Hmm, I believe you mentioned Catholicism in your initial comment, which is what I addressed. Ah, a Pre-Vatican II mindset...makes sense now. Well, if that is what you want to believe. Whatever helps you feel better about yourself. But, perhaps have some compassion for others who have different life experiences than yours. As I'm sure you are aware, Jesus' ministry included the tax collectors, the poor, the sick, the prostitutes, the criminals, the Gentiles. The outcasts of society. Not those who used the Law against people and viewed themselves as more faith-filled than others, like the Pharisees did.

Rhett Segall
4 years 10 months ago

It is important to recognize that religious truth and practices are not as such obstacles to sanity. In fact they promote seeing things as they are. However, I agree with CS Lewis who sees as diabolical promoting Christianity as such as the helper to various human endeavors, e. g. "Christianity and democracy", "Christianity and vegetarianism" and, yes, and even "Christianity and ecology". No, Christianity should be offered and presented simply because it is the truth of things!

Trent Shannon
4 years 10 months ago

There are multiple aspects of treatment of depression and anxiety to begin with. Medication is one part, therapy is another, support groups a third, and the fourth recommendation is meditation - mine just happens to be the rosary

Finding faith was a big step in my treatment of bipolar (which is not general depression or anxiety) - in part introducing me to the rosary, but mostly for giving me a social entry from being isolated as part of my illness

I think this quasi experiment is very poor form, and may be read as a "stop taking meds, come to church" message - especially dropping that NIH link, which says a lot more than meds working in 20% of cases, but doesn't break down whether the control/test groups have mental illness, what level of mental illness (a three week low period or lifelong illness like I have), and what meds used (I'm three of them), and doesn't take into account the holistic approach needed for mental illness (the other three things mentioned above)

Faith might work for me as part of that mix, but it won't work for everyone; just as meds might work for me, but not for everyone. Be careful with what you publish, it might send a rough message that has unintended, possibly dangerous consequences.

Alan Johnstone
4 years 9 months ago

OK, so I bring Judas to you for therapy.
What wisdom of science do you guarantee would turn him away from betraying Yeshua and avoiding suicide?

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