Religion and Depression – Cause or Effect?

With the season of Easter and Passover upon us (significant celebrations in the lives of Christians and Jews, respectively), people who are not normally involved in religious activities seem to find their way back to sunrise services and family seders. Many studies have extolled the benefits of religious involvement on mental health and overall well-being, but a new study questions the associations and claims that depression and religious attendance may exhibit more cause-and-effect than previously believed.

The authors of a new study, published in the American Journal of Epidemiology, evaluated the religious involvement and mental health of three separate cohorts of individuals, totaling more than 2000 people, living in Rhode Island. The average age was 37 years old; most of the study participants were Caucasian and had a Catholic upbringing. More than 90% of the participants reported religious involvement as a child, but only half reported the same as adults. Slightly more than one-quarter of the participants received a diagnosis of major depression at some point in their life, with one-third of these receiving the diagnosis during childhood or adolescence.

Overall, women with a diagnosis of major depression before 18 years of age were significantly more likely to stop attending religious services as an adult than women with no diagnosis of major depression or a diagnosis after the age of 18. There were no significant associations between religious involvement and men.

Religious involvement changes over the course of one’s lifetime, but most data still points to any religious involvement as protective against depression and other mental illnesses across both genders and all age groups.

The authors of the current study believe that the robust claims of a protective effect between religion and depression may be owed to the fact that people with depression drop out of religious involvement, thus skewing the data of those that remain involved. Two potential cause-and-effect scenarios are presented that might explain the results. First, religious involvement leads to positive social support and healthy behaviors, which leads to a decreased risk of depression. Alternatively, at the onset of depression, people begin to experience negative emotions and interactions with religious activities and feelings of alienation and guilt, which leads to a decreased involvement in religious activities altogether. (Dropping out of previously positive and pleasurable activities — religious or not — is an independent indicator of depression.)  This selection out of religion, the authors believe, contributes to the previously reported correlations between religion and mental health.

The authors end the manuscript with a discussion of the limitations of the study and a call for future long-term research into this issue. My question is, Why? Do they want depressed people to stay in church so the association between religion and mental health is proved false? Do they want non-depressed people to stop attending church, since there are no supposed health benefits? Neither is plausible or realistic, and the results of any future study will not contribute to changing patterns of religious attendance.

People don’t attend church because of the health benefits. If you feel good about your spiritual life, you probably feel good about your physical life, but there are plenty of church-goers with mental and physical health issues. And, just as many non-goers who are pictures of health. Religious involvement is a personal decision and reducing its explanation to a single measurement of depression is dangerous from a statistical and spiritual point of view.


Jacobs M, Miller L, Wickramaratne P, Gameroff M, & Weissman MM (2012). Family religion and psychopathology in children of depressed mothers: ten-year follow-up. Journal of affective disorders, 136 (3), 320-7 PMID: 22177740

Maselko J, & Buka S (2008). Religious activity and lifetime prevalence of psychiatric disorder. Social psychiatry and psychiatric epidemiology, 43 (1), 18-24 PMID: 17960316

Maselko J, Gilman SE, & Buka S (2009). Religious service attendance and spiritual well-being are differentially associated with risk of major depression. Psychological medicine, 39 (6), 1009-17 PMID: 18834554

Maselko J, Hayward RD, Hanlon A, Buka S, & Meador K (2012). Religious service attendance and major depression: a case of reverse causality? American journal of epidemiology, 175 (6), 576-83 PMID: 22350581

Miller L, Wickramaratne P, Gameroff MJ, Sage M, Tenke CE, & Weissman MM (2012). Religiosity and major depression in adults at high risk: a ten-year prospective study. The American journal of psychiatry, 169 (1), 89-94 PMID: 21865527

Image via Rechitan Sorin / Shutterstock.

Jennifer Gibson, PharmD

Jennifer Gibson, PharmD, is a practicing clinical pharmacist and medical writer/editor with experience in researching and preparing scientific publications, developing public relations materials, creating educational resources and presentations, and editing technical manuscripts. She is the owner of Excalibur Scientific, LLC.
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