notes on religion and health

I was updating my list of "Further Reading" books, and realized a couple books I had on there previously were dropped when I switched from the old blogger. (Some of my blogroll was also lost; my apologies if your blog is not on my list--just let me know!)

The two books I recognized as lost were God, Faith, and Health: Exploring the Spirituality-Healing Connection, by Jeffrey Levin, and Blind Faith: The Unholy Alliance of Medicine and Religion, by Richard P. Sloan. I read them both for a class I took, and looking through my classwork, I found some of my notes about the books.

Koenig [who he is, I can't for the life of me remember] argues that health benefits might only come to those who are intrinsically religious; this leads me to wonder about all those people who are extrinsically religious, but belong to religions that do not let them admit that. Are they not only getting no benefits, but are they also harmed by religion? Even Levin acknowledges that such people exist in his comment about “the exceptions, such as people whose emotional well-being is harmed by religion” (Levin, p. 8). It is easy for Levin to say, “If we find that how we worship is only making us more miserable, then it may be time to find a new way to pray” (p. 92). However, for people in conservative religions especially, Levin has a frustratingly simple view of people’s ability to switch religions or styles of worship. If religion is paid better attention to in public health and medical practice, it should be to find those people for whom religion causes negative health outcomes, particularly with regards to mental health. Much more research needs to be done to even tease out these effects and to determine how widespread they are. Unfortunately, at this stage most studies on religion and health are financially supported by religious funders; it is in their interest to ignore religion and negative health outcomes.

The application of findings of religious studies to medical or public health practice should only be done only with great caution. The studies are indeterminate enough that medicine cannot go beyond saying religiousness/spirituality may have benefits for prevention of chronic disease in general, particularly with regards to providing social support, reducing rates of high-risk behaviors, and providing time to relieve stress. But this ignores the cases in religious communities where social support morphs to coercive demands for social conformity; where youth are ignorant about how to protect themselves from STDs because of demands for absolute abstinence; and where participation causes stress. These cannot be simply ignored.

If findings were to be used in practice, it would best be secularized first. For example, doctors and public health interventions could recommend people find social groups, reduce risk-behaviors, and take time out of each day to relieve stress. The recommendation could then list possible forms of social groups, with church groups as one example of many, and possible forms of stress-relief, such as yoga, breathing, prayer, meditation, etc. Religion should not be ignored, but it also should not be trumpeted as a panacea, especially given that membership in a religious community stems from many reasons, not limited to an actual desire to be a member.

Mormonism and depression: literature

This is kind of a cop-out post because I don't have time to write much lately, but maybe this will help some people. What follows is a short-list of what resources I have pulled together on Mormonism and depression. Doubtless, there is more out there, and I have concentrated more on scholarly, peer-reviewed literature. If you have anything to add to the bibliography, please let me know. Also, if you would like a copy of anything, let me know at fromtheashesblog@gmail.com. For the items that are available online, I have provided links. (A hearty thanks to those of you who helped me find some of these in the first place.)

I will thoroughly read each of these and write some notes on them when I have more time.

Gray literature (not peer-reviewed)

Ponder, Kent. Mormon Women, Prozac, and Therapy

LDS Use of Antidepressants. entry on FAIR's Wiki.

Express Scripts Prescription Drug Atlas. Executive Summary. (This report is, as far as I can tell, The Source for the idea that Utah has the highest anti-depressant rate. I'll write a post about it.)

Media reports

Julie Cart, "Study Finds Utah Leads Nation in Antidepressant Use," Los Angeles Times, 20 February 2002, A6. (I can't access a copy of this online without paying, but I have the abstract.)

Utah leads the nation in antidepressants and analgesics, study concludes. The Associated Press State & Local Wire. June 21, 2001.

Carey Hamilton. The Salt Lake Tribune. Critics question use of antidepressants; Health: Some call the medications dangerous; Utah, meanwhile, leads the nation in their consumption; Medication criticized by coalition. September 5, 2003.

"Expert: Mormon women less depressed," USA Today, 2 April 2004 (Associated Press article).

Degn, L. Yeates, E. Greenwell, B. Fiddler, L. 1985. Mormon women and depression [transcript of the KSL documentary of the same name]. Sunstone. 49: 19-27.

Peer-reviewed literature

Bauer, Leslie E. 1992. Depression and repression among Mormon women. Dissertation. California State University, Fresno.

Hilton, Sterling C, et al. 2002. Suicide Rates and Religious Commitment in Young Adult Males in Utah. American Journal of Epidemiology. Vol. 155, No. 5: 413-19.

Maxwell, Jeanmarie. 1992. Mormon women and depression. Thesis. University of Nevada, Las Vegas.

Norton, Maria C, et al. 2006. Gender Difference in the Association Between Religion Involvement and Depression: The Cache County (Utah) Study. Journal of Gerontology: Psychological Sciences. Vol 61B, No 3: 129-136.

Overton, Jared L. Latter-day Saints and Mental Health: A Review of the Literature, 1995-2005. Dissertation. Azusa Pacific University.

Spendlove, David C. 1982. Depression in Mormon Women. Dissertation. University of Utah.

Spendlove, David C., et al. 1984. Risk Factors and the Prevalence of Depression in Mormon Women. Social Science and Medicine. Vol 18, No 6: 491-495.

Williams, Marleen. 1993. Correlates of Beck Depression Inventory Scores in Mormon and Protestant women: Religious orientation, traditional family attitudes and perfectionism. Dissertation. Brigham Young University.

pretend like everything is perfectly normal

While my parents know to some extent my "struggles" with the church, and they know I don't attend church, I've never right out told them the degree of my non-belief. They cast me in the "struggling with my testimony" category, while I put myself in the "the church has no claims to the truth, is destructive in many ways, and certainly isn't right for me" kind of place. Oh, and I don't believe there's an actual supreme being. But since so many people believe there is and act like there is, and it influences who they marry, how they live, what wars they start, etc., there is God in an abstract sense. In a metaphorical sense. So I don't mind talking about God in an intellectual way without feeling the need to blurt out, "But God isn't real!"

Anyway, I've been thinking lately that maybe I could start to be more open with my parents, that maybe our relationship could benefit from my letting them know a little more about me. Like send them the letter I never sent when I first started seriously questioning. Or use my real name when I record my exit story on podcast for mormonstories. I'm getting more comfortable with my new self, so maybe I could handle them knowing me better.

Then a conversation with my mom made me think, "maybe not." I started talking to my mom about this book I'm reading about the connections between religiosity and health. I tried to be nice about it, and admit that there are a couple studies that actually hold up to pretty good academic rigor that show people who attend church often (2+ a week) live longer (as a group) than people who don't attend. I explained how some of the reasons this is so are measurable and biologically plausible: social support, less smoking, less alcohol, less risky sex, hope & optimism, de-stressing, etc.

Perhaps my next sentence was my mistake. I said, but even after taking these factors into account,the studies still show some benefit to being an church attender. Some believers would jump on this and say, Ah ha! God is blessing those people! I tried to explain that to my mom, but she butted in, sounding impatient and annoyed, with, "Well, isn't that why the Lord tells us what to do and how to do it to be healthy?"

The conversation took a nose dive. Why did I think I could have an academic discussion with my TBM mom about religion? How could I be so optimistic?

I wanted to say, "Only if you believe God did such a thing. Remember, Mom, that I don't believe it? Skeptics like me would say this study result could be because there are some factors left unmeasured, that, once measured, would account for the extra mortality for non-attenders. "

I actually said, "Well, these studies are science, not religion, so they can only measure so much. You can't measure God, you can't measure God interceding. They can only measure what they can observe, right? Anyway, the idea is interesting."

I really wanted to tell her about some other research in this area, about intercessory prayer (praying to ask God for actual intervention, rather than praying to worship or feel a connection) and post-heart surgery complications. These studies show quite clearly that having people pray for patients to have speedy recoveries does not help. In one study, it actually hurt. People who had others praying for them, and who knew the others were praying for them, had the highest numbers of complications. (See Benson, et al. "Study of the Therapeutic Effects of Intercessory Prayer (STEP) in Cardiac Bypass Patients." American Heart Journal. Vol 151, No. 4.)

I would have loved to tell her about that study. But either I'm too much of a coward, or I'm too nice. Or both. But why tell her? It just would have made her mad. She wouldn't have agreed with it. She would have found some way around it. She would have given testimony that she has prayed and received answers, that she has prayed for certain outcomes and gotten them. And that God shouldn't be put to the test like that anyway.

And then I think, Maybe she's not ready to get to know the current me. And I'm not ready to introduce myself. Lately, I've been thinking maybe I'm not giving them enough credit for how they handle my disaffection. This conversation made me think maybe I'm giving them too much.

And that hurts. She's my mom; I'm her daughter. We should be able to talk. But we never have been able to, really. This isn't just about Mormonism, this is about dysfunctional communication lines. There's just that much more reason to try to fix the problem now that there's something important to talk about. And that much more reason to just leave it alone.

Note to self: Quit bringing up religion with Mom.

god, faith, and health

I've been reading a book, God, Faith, and Health: Exploring the Spirituality-Healing Connection by Jeff Levin. This book is a little out of form for me, but I'm also reading Blind Faith: the Unholy Alliance of Religion and Medicine by Richard Sloan, so it's somewhat balanced out. There's Levin, the rabidly pro-religion guy, who will make sure just about any evidence supports his conclusion, and Sloan, the cynic, who will argue away just about any evidence that supports religion.

The former author is convinced that being religious and/or spiritual both prevents and heals infectious, chronic, and mental illnesses, and gives tiny summaries of any article he can find that supports this. Now, there is something to be said for the connection--people who go to church have extra social support, have weekly or daily moments in which to de-stress, are less likely to drink heavily, have risky sex, etc., and people who are spiritual may have a certain level of hope, etc. that helps them have a positive outlook on life. All that will certainly help your health.

But this book goes a little extreme, in my opinion, and let's say, fudges some of the studies' interpretations, leaves out crucial information about the validity of some studies, and is downright flabbergasting in some interpretations (manipulations) of study results.

Now one problem I have with Levin's writing is that he fudged over some results, and passes them off as conclusive. He'd write, for example, that studies have shown church attendance to lower your risk of high blood pressure, pancreatic cancer, herpes, and obesity, when really, the only studies that made those connections were entirely exploratory. Many of them were most likely random errors, and none of them could possibly show causality. If you're looking at enough behaviors and enough diseases, a few of them are bound to show a connection just by chance.

So I'd reading this book, feeling pretty shitty about it, because he's trumpeting how there's so much evidence that religion makes your life better, your mind and body healthier. And I'm thinking 1) the evidence isn't that great; and 2) what about me? The book almost completely ignores what happens to people like me. People for whom religion didn't work, for whom religion creates problems rather than reduces them. He comes close, with this quote:

"My own perspective is that worship should be an uplifting experience. ...One worship service or a single prayer or twenty minutes of quiet reflection may not leave our spirit soaring with the eagles, but God willing, it should not send us sinking any lower. If we find that how we worship is only making us more miserable, then it may be time to find a new way to pray" (p. 92).

That's his advice? Find a new way to pray? Take it from me and the rest of the DAMU: it's just not that simple.