For many centuries, churches and other religious institutions played an important role in caring for those with mental illness. In fact, leaders of religious orders were arguably the first to recognize that those with mental illness should be treated with kindness and not simply locked away.
But about 150 years ago, a rift started to develop between religion and psychiatry. Many have since taught that religion can cause or worsen mental illness. Some have gone so far as to profess that religion itself was a manifestation of mental disturbance. Much of this can be traced back to Sigmund Freud, the eccentric Austrian psychiatrist who conceptualized religion as a “universal obsessional neurosis.” Freud believed religious impulses stemmed from unfulfilled childhood desires for a dominant father figure. As such, he believed that our collective mental health would be better off if we abandoned religion altogether.
Then there was Albert Ellis, one of the most influential therapists of the 1900s, who wrote that “Devout … religion is significantly correlated with emotional disturbance.” Like Freud, Ellis proposed that mental health would improve when religion was discarded. “The elegant therapeutic solution to emotional problems is to be quite unreligious,” he wrote.
Institutional religion often provides robust social networks, a strong sense of community and more stable marriages (all of which lead to better mental health).
The views of highly influential academics such as Freud and Ellis have undoubtedly influenced the lens through which many therapists and practitioners have viewed religion for the past 100 years. Yet these so-called experts were not informed by rigorous research. It wasn’t until the 1980s that scholars started conducting systematic investigations into the relationship between religion and mental health. Since that time, a huge amount of evidence has amassed. What has this research shown? Does religion help or — with its strict prohibitions on certain behaviors —exacerbate mental illness?
The late Michael Gerson, a former journalist for The Washington Post, would argue the former. In 2019, Gerson found himself institutionalized for severe depression. He recorded in his journal the thoughts that went through his mind as he passed the time in a locked psychiatric ward: “You are a burden to your friends. You have no future.”
“The scary thing,” Gerson later recalled, “is that these things felt completely true when I wrote them.” He was convinced that everyone hated him, and he was plagued by an inescapable feeling of hopelessness. Fortunately, he received excellent treatment from doctors and nurses who recognized that his thoughts were delusional.
But what also helped Gerson, a practicing evangelical Christian, was not argument or rationality. As he recalled, it was his “experience of transcendence” that helped provide a mooring belief that the universe is not ultimately cold and chaotic. Instead, his recognition of the miracle of life provided hope and comfort, which aided his psychic healing. As part of his recovery from a devastating despair, Gerson recalled in a column, “faith helped me remember how to live.”
What does research show about faith and mental health?
But is Gerson’s story representative of the broader pattern? Is faith generally helpful for preventing or recovering from mental health challenges? Or are the views of Freud and Ellis correct, that religious belief and practice lead to emotional disturbances?
The fact is that most of the data flatly contradicts Freud and supports Gerson, showing that participating in organized religion protects against mental illness. This is seen through numerous large and nationally representative surveys. In the vast majority of cases, those who report attending church, mosque or synagogue on a frequent basis have lower symptoms of depression and anxiety compared to those who never or rarely attend.
But these surveys can only examine one point in time. They can’t necessarily prove that religious participation causes people to be less depressed. It’s also possible that if I’m so depressed I can hardly get out of bed, I’m less likely to shout praises in the local parish choir. While it’s very possible (and indeed likely) that this provides part of the explanation, there’s also good reason to believe that religion causes people to be less depressed, less anxious, and on the whole more mentally balanced.
One of the highest quality analyses that investigates the relationship between religion and depression was conducted by researchers at Harvard University. This team, led by professor Tyler VanderWeele, analyzed data from nearly 49,000 women who were followed for 12 years. Because this study followed so many participants over time, VanderWeele and his colleagues were able to decipher which change occurred first, the religion or the depression. Moreover, they also accounted for numerous other characteristics and used sophisticated methods to measure cause-and-effect relationships (and not just correlations). The data showed that frequent religious attendance was associated with about a 30% lower incidence of depression.
More broadly, in a rigorous review of more than 400 studies that examined the relationship between religion and depression, most studies (61%) found less depression among those who were more religious. A few (6%) found more depression among those who were more religious, and the remainder found no relationship between depression and religious participation. In general, studies that were of higher quality show a stronger relationship between more religious observance and less depression. (There’s an important exception, however. If you see God as angry, unloving or overly controlling, then religion may be linked to more depression and anxiety, not less.)
Can you will religious belief?
The hardened skeptic may still protest that most of the results showing a link between more religion and less mental illness are taken from observational studies. The only way to know with certainty if a given factor (in this case, religion) causes less mental illness is through a randomized experiment, where some people are (through random assignment) exposed to the factor and others are not. This type of experiment — the randomized trial — is revered in medical science as the gold standard method for establishing causal relationships.
Of course, you can’t really randomly assign people to be religious or not. As the prominent British biologist and atheist Richard Dawkins points out: “believing is not something you can decide to do as a matter of policy. At least, it’s not something I can decide to do as an act of will. I can decide to go to church and I can decide to recite the Nicene Creed, and I can decide to swear on a stack of Bibles that I believe every word in them. But none of that can make me actually believe it if I don’t.”
We take some issue with Dawkins’ conclusion that personal will has no role in what someone believes. But, for the sake of argument, let us concede Dawkins’ point. His perspective, however, still leaves open the possibility that, at least in theory, you can randomly assign people to religious behaviors, though this clearly only gets at a part of what religion is. Even so, this religion-by-assignment leads to less depression and more happiness. Imagine a doctor handing you a prescription, but instead of medication, it says: “Attend religious discussions, practice gratitude, and pray regularly.” While this sounds strange, researchers have put this idea to the test. And the results show that, on the whole, simply doing religious things — whether that’s listening to the Quran or practicing Christian mindfulness methods — makes people less depressed.
There are a number of plausible reasons why religion protects against the ravages of mental illness. Institutional religion often provides robust social networks, a strong sense of community and more stable marriages (all of which lead to better mental health). In addition, practices of mindfulness and meditation, which are usually encouraged by religious leaders, have calming effects. Moreover, many religious traditions teach that anyone can cultivate a personal relationship with the ruler of the universe through prayer. Hence, at any given moment, an individual who is struggling with loneliness, self-doubt or uncertainty can commune with a divine and benevolent creator.
None of this is to suggest that supportive religious communities obviate the need for continued secular investments in better ways to treat mental illness. And individuals with serious or persistent symptoms of mental illness should seek help from competent professionals in addition to soliciting prayers from the local priest, pastor or rabbi. But as rates of depression and anxiety continue to rise (alongside falling rates of religious service attendance), we ought to remember and take advantage of institutional religion as an important source of mental well-being.
Dr. Samuel T. Wilkinson is an associate professor of psychiatry at the Yale School of Medicine and the medical director of the Yale Depression Research Program. He is a fellow at the Wheatley Institute at BYU and is also the author of “Purpose: What Evolution and Human Nature Imply About the Meaning of Our Existence.” Stephen Cranney is a nonresident fellow at Baylor University’s Institute for the Studies of Religion and teaches at The Catholic University of America.