There is so much confusion about what the causes of mental
disorders are and what prevents mental disorders. There is so much
confusion about what the concept of “risk factors” means and what the
concept of “protective factors” means. And for many years, some of the
research in these areas has been contributing to this confusion.
One of the most commonly held confusions is that
about what causes or prevents depression. In my opinion, there is
probably more nonsense written about those issues than about almost anything
else pertaining to mental health and mental illness – except maybe for
medications used to treat mental illness.
Much of this confusion comes from or is related
to our very simplistic models of causality – that is, our thinking about what causes
what. We often think of causality as linear – so that something that
comes before the event (or diagnosis) is considered to cause that event (or
diagnosis). As we know in our frontal lobes, this kind of linear model is
rare. Mostly causality is multi-factoral and sometimes the most
substantive “causal” factors are not readily apparent. So people get lazy
in their thinking and go into brain default mode – choosing to assume that what
comes first causes what happens after. This of course is using our limbic
systems as explanation. Not a good way to be less wrong most of the time.
Depression does not arise in one day. It
takes a long time between when the illness begins and a diagnosis is
made. If you (as most researchers to date have done) look at events
preceding the diagnosis of depression you will get a very skewed and biased
idea of what may have “caused” the depression. As a person is getting
depressed, they may create events that are due to the depression and not the
other way around. Lazy thinkers then make a completely incorrect causal
inference. They could not be more wrong!
Enter some hard thinking researchers. They
decided to investigate the link between religion and depression. Many who
did earlier cross-section studies found that depressed people went to church
less often than those who were not depressed. So what did they conclude:
that being religious prevented depression! Ouch – and this idea has been
around for so long that many people thought it was true!
So here is the new lens. It’s a
prospective study (so not a cross-sectional analysis) that followed people over
time led by Dr. Joanna Maselko of Duke University and published in the American
Journal of Epidemiology in February 2012: http://bit.ly/AmDqcl.
And what did they find? They found that
contrary to current mythology, religion does not prevent depression! What
they found is that as people became depressed, they stopped going to
church! Social withdrawal was
a result of the depression, not the other way around.
So, is addressing spirituality for people a
waste of time? Likely not. Will that prevent depression – no.
What should we learn from this information?
We need to stop thinking about causality in linear fashion and we need to start
doing research that can give us answers to questions in a best evidence way –
not jumping to conclusions that reinforce our biases. Isn’t science
grand? It’s the only system that we have that is independent of our
ideologies. We need to use it more – for everything.
-Stan