more on depression

These past few weeks I've been perusing the academic literature on Mormonism, as you will have noticed if you're a regular reader. I'm eventually hoping to find the time to turn this into a paper, but for now, I'll share some basic results and take-home messages from three of the studies.

Spendlove, Risk Factors and the Prevalence of Depression in Mormon Women, 1984

This study telephone-interviewed 143 Mormon women and 36 non-Mormon women in the Salt Lake area. They found that 23.8% of the Mormon women were depressed (based on a screening done during the interview), and 22.2% of the non-Mormon women were. So there was no difference in prevalence of depression. They also compared highly-religious Mormon women to not-so-religious Mormon women, and found that there were differences in depression, the "inactives" having more depression. However, when they took into account income, education, caring from spouse, and health status, they found that those differences explained the difference in depression--not activity levels. (I wrote more about this study here.)

What's interesting here is that the depression rates for both groups were quite elevated. The depression rate among US women is more like 3%. Part of this difference is due to measurement--the depression rates in the Spendlove study were found through a screening by phone. The 3% rate is probably something like diagnosed-by-clinicians rate, which is certainly lower than the actual rate. Most depression is undiagnosed (get an online screening!). Still, the gap is too wide to be explained away by measurement error.

There was no difference between prevalence rates for these two groups, leading the authors to conclude that Mormon women do not have higher rates of depression that non-Mormons. However, one must also consider that both groups have elevated rates. Why? I could speculate that Mormons have elevated rates for certain reasons pertaining to being Mormon, while the non-Mormons have other reasons for being depressed, such as social pressures of being the religious minority. Hmm. Further studies are needed...Some have been done looking at Mormons outside of Utah. I'll get to those another day.

Fellingham, 2000, Statistics on Suicide and LDS Church Involvement in Males Age 15-34

Okay, this one is not depression specifically, it's suicide, but a lot of suicide results from depression. This Utah-based study looked at death records of boys and men, and checked church records for which office of the priesthood they had attained (Aaronic or Melchizedek). They decided that if a 15-19 year old had the Aaronic priesthood, or a 20-34 year old had the Melchizedek priesthood, he was active. Otherwise they were classified as "inactive" or "non-member." Not a perfect measure, but it was probably the best they could do in the circumstances. The results were rather disturbing: active Mormons had the lowest suicide rates. The general US male population in the age group were 2.5 times as likely to commit suicide as "active" Mormons. "Inactive" Mormons were 4 times as likely to commit suicide, and non-Mormons living in Utah were 6 times as likely to commit suicide. Yikes.

Perhaps the scariest part of this study is that some Mormons would think (read: this is what I would have thought when I was a believer) that this is just proof that being an active Mormon is better. And that the solution is just to re-activate all those "inactives." Simple, right?

There are a couple things I see that are wrong with that logic. First, this study in no way establishes causality. A reader cannot conclude that because they happened to be inactive when they committed suicide, it was the inactivity that caused the suicide. It could have been that mental illness (supposing it was mental illness that led to the suicide) caused the inactivity. Or there could have been an issue (say, he told the bishop he was gay) that caused the bishop to deny advancement in the priesthood, even though the young man was a faithful believer, and perhaps even led to the suicide. There are a lot of scenarios I could come up with; we just don't know.

Second, perhaps it's not something wrong with the "inactive" and non-Mormon boys and men, but with the system in which they live. Maybe it's not the "inactive" ones that are doing something wrong, but it's the church that's wrong for them. Obviously, many Mormons live happy lives. I was happy as a Mormon. But there are some for whom it simply doesn't work; for some, it hurts. These people are the ones more likely to become "inactive." A problem is, though, that there is little room in the church--and especially in Utah--to recognize that it could be something wrong with the church, and not a personal failure or sin of the person for whom it doesn't work. Instead of trying to re-activate the "inactives," it would probably be more appropriate to target those at risk and find out what they need--counseling, therapy, anti-depressants, social networks outside the church, maybe even social networks inside the church. Of course, there is a huge range of reasons why they stop going to church, why they develop mental health problems, and why they commit suicide, and my late-night musings can hardly do any of that justice. So I'll move on.

Norton, Gender Differences in the Association Between Religious Involvement and Depression: The Cache County (Utah) Study, 2006

This study involved interviews with 4468 elderly people (65-100) in Cache County, Utah. More than 90% of them were Mormon. They found that people who attended church more frequently had lower rates of depression (remember, this is not causality, but rather correlation). They also found that the Mormons had twice as much depression that non-Mormons, even after considering other risk factors. This was the most interesting finding to me, but the authors gloss it over in one sentence in the discussion section. That's it.* What the authors considered most interesting was that there was a difference by gender. Women had less risk of depression if they attended frequently, but it was the opposite for men. The ones attended more frequently were more likely to be depressed.

This isn't the first study to find different effects by gender. Many studies show that attending women are benefited more by religiosity than attending men (and that women attend more than men). The authors speculate that the reason men in this group had higher depression was because of loss of social role. That is, it's the younger (middle age) men who hold the important leadership positions, such as bishop, stake president, high council. By the time they are 65+, men generally don't hold these positions (unless they are in the general leadership, which is very small percentage of men). They authors also speculate that for men, church is more business-like, and for women, it's more social/emotional. Thus, older women would benefit from the social contacts at church, while men would more likely feel the loss of being in charge.


* I owe this insight to my husband.