How does spirituality relate to mental health?

Introduction

Both spirituality and mental health have multiple dimensions, which makes summary statements about their connection complex. Spirituality may involve traditional religiousness (such as attendance at religious services or congregational support), a sense of transcendence or connection with the divine, or behaviors such as meditation and prayer. Mental health may range from psychopathology, such as depression, anxiety, and substance abuse, to positive mental states, such as happiness and life satisfaction.

Research findings generally indicate that spirituality is correlated with better mental health, although causality has not been shown. Most of this research has specifically examined the religiousness-mental health link. Harold Koenig, Michael McCullough, and David Larson conducted a major review of 850 studies on this topic in 2001. They found that higher levels of spirituality generally related to less psychopathology and higher levels of psychological well-being. In 2014, Moreira-Almeida and Koenig published a review and summary of their analysis of over one thousand papers on the subject of spirituality and mental health. They provide the evidence and guidelines most agreed on in terms of the efficacy of incorporating religion and spirituality into clinical practice.

Spirituality has been shown to be modestly associated with lower levels of clinical depression, depressive symptoms, and negative mood states. In addition, many dimensions of spirituality appear to protect against suicidal behavior or ideation. These effects seem to be stronger for spirituality related to service attendance and integration in spiritual communities. In addition, spirituality is related to lower levels of a range of anxiety disorders, including phobias, panic disorder, and generalized anxiety disorder, and to lower levels of anxious mood in general population samples. In particular, individuals who have higher levels of social connections through their spirituality and who use spiritual coping methods or find comfort in their beliefs are less inclined to anxiety and anxiety disorders.

There is little evidence that spirituality is related to schizophrenia or obsessive-compulsive disorder, but the delusions of those diagnosed with the former and the obsessions and compulsions of those diagnosed with the latter often contain spiritual, particularly religious, elements.

Spirituality consistently relates to less abuse of or dependence on alcohol and other drugs, including marijuana, heroin, and nicotine. The fact that use or abuse of intoxicating substances is forbidden by certain religious groups makes usage low among the followers of these groups. Those who use more religious coping, feel a stronger connection to the transcendent, or have a more active private spiritual life, including prayer and meditation, are less likely to use or be dependent on alcohol and other drugs.

Myriad studies have demonstrated that spirituality is favorably correlated with positive mental health and psychological well-being, including measures such as life and relationship satisfaction, happiness, and higher morale. These findings have been demonstrated for a number of aspects of spirituality, including service attendance, a sense of connection to the transcendent, spiritual beliefs, and the use of spiritual coping in the context of stressful events.

Many dimensions of spirituality are related to mental health. These relationships are, for the most part, modest in strength but are found consistently in numerous studies conducted in samples diverse in race, ethnicity, socioeconomic status, gender, age, and religious affiliation. A caveat to these findings, however, is that research shows associations but has not demonstrated causal relationships between spirituality and mental health. Based on these positive links, psychotherapies are being developed and implemented to assist clients in drawing on their spiritual resources.

However, some experts note that religion and spirituality are not always conducive to good mental health. A study in the December, 2007, issue of the American Journal of Psychiatry found that 21 percent of psychiatrists thought that religion had equally negative and positive effects on mental health. Some 82 percent found that religion or spirituality could cause guilt, anxiety, or other negative emotions that increased patients’ suffering. Other studies have linked religion with failure to comply with treatment or fatalistic attitudes toward illness. Other studies have linked religion with the use of extensive medical procedures to prolong life, hoping for a medical miracle. Excessive religiosity also has been linked to adverse mental health effects, both on the individual and on the person’s children.

Pathways of Influence

The pathways through which spirituality may influence mental health are diverse and include the promotion of healthier lifestyles and positive psychological states, the reduction of stress, and the provision of social support, meaning, and resources that aid in more adaptive coping in stressful situations.

Many individuals derive a sense of meaning or purpose in their lives through their spirituality. This sense of meaning provides direction and grounding and also seems to help buffer against the stresses of life, thus protecting against psychopathology. Some types of spirituality also directly promote taking better care of one’s physical and mental health by engaging in a lifestyle that incorporates preventive health care behaviors, a healthful diet, and regular exercise. Such a lifestyle leads to more robust physical and mental health. In addition, spirituality can help bring about positive psychological states that promote mental health; these include gratitude, hope, optimism, awe, forgiveness, and being at peace.

Spirituality offers many positive social aspects, which can provide support, a sense of value and belonging, integration into a social network, and the comfort of a shared belief system. These aspects of social support provide strong protection against psychopathology, especially depression.

Spirituality can foster particular beliefs that allow more benign interpretations of potentially stressful events, lessening the impact of minor and major life stressors. In addition, spirituality provides a range of coping behaviors, including engaging in prayer and relying on the religious community for support. These coping resources have been shown to lower distress and promote better mental health.

Bibliography

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Hackney, C. H., and G. S. Sanders. “Religiosity and Mental Health: A Meta-analysis of Recent Studies.” Journal for the Scientific Study of Religion 42 (2003): 43–55. Print.

Koenig, H. G., M. McCullough, and D. B. Larson. Handbook of Religion and Health: A Century of Research Reviewed. New York: Oxford UP, 2001. Print.

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Moreira-Almeida, Alexander, Harold G. Koenig, and Giancarlo Lucchetti. "Clinical Implications of Spirituality to Mental Health: Review of Evidence and Practical Guidelines." Revista Brasileira de Psiquiatria 36.2 (2014): 176–82. Print.

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