Synopsis: 7 million Christians in the US experience major depression each year. While attendance of religious services might be protective, it is not protective enough. This article discusses research on Christians with depression, the impact of stigma and how I calculated the number of depressed Christians.

BY LEN LANTZ, MD / 1.23.21; No. 45 / 6 min read

Disclaimer: Yes, I am a physician, but I’m not your doctor, and this article does not create a doctor-patient relationship. This article is for educational purposes and should not be seen as medical advice. You should consult with your physician before you rely on this information. This post might also contain affiliate links. Please click this LINK for the full disclaimer.

Where I found the number 7 million

I calculated it.

The number of depressed Christians in America is not something you can just look up in a medical journal or public health website. This is because all people who identify as Christians are not the same. There are different denominations, different rates of church attendance and different levels of adherence to orthodoxy. While it could be argued that the prevalence of Christians with depression should be measured as a part of a regularly followed metric in public health, it is not.

For my calculations, I used data from 2017, 2018 and 2019 from the Pew Research Center. From their data set, it is estimated that 106.8 million Christians attend church at least once or twice a month. The National Institute of Mental Health lists the prevalence of having a major depressive episode in 2017 at 7.1%. Applying the 7.1% rate to 106.8 million Christians allows us to arrive at the number 7.6 million. So, calculating the number of Christians with depression becomes a matter of simple math, right?

Maybe not.

Christianity might be associated with lower depression rates

There is research showing both increased and decreased rates of depression in Christians compared to the general population. However, one of the largest metanalyses suggests there is a minimal-to-mild decrease in depression rates among Christians (Smith et al. Psychol Bull. 2003). There are some challenges with larger studies as they often do not look at the Christian religion alone, although studies of Christians predominate these metanalyses. The actual finding in medical research is that religiosity is associated with slightly lower rates of depression (Thomas, et al. Religions. 2020).

Research also has not proven whether going to church decreases the likelihood of depression or if less depressed people are more likely to go to church. There also could be a reporting bias in some studies. Being a Christian does not guarantee a lower risk of depression. It may be that Christians who attend church have less depression because of other factors associated with church attendance, including:

• Decreased substance abuse

• Higher social support

• Reduced “perceived stressfulness” of negative life events

• Better coping with stress

Why would I stick with the number 7 million?

There are several reasons why I believe that it is accurate that 7 million Christians in the US have depression. The top reason supporting the calculation is that some studies show an increase in depression among Christians. The second reason I would stick with the number of 7 million is that there have been no previous wide-scale, national measurements of prevalence of depression among Christians or a reliable way to account for a potential protective factor of Christianity on depression. While it was found in a large metanalysis that “greater religiousness is mildly associated with fewer symptoms” (Smith et al. Psychol Bull. 2003), this finding does not generate a mathematical way to potentially “correct” the calculated rate of depression among Christians compared to the general population. A final reason is that we are now in the year 2021, and the depression rates and US population continue to increase each year. The calculation in which I estimated that 7 million Christians had depression was from 2017 data.

Why aren’t Christians significantly less depressed than the general population?

There are several reasons why Christian faith may not substantially reduce the risk of depression. Faith is only one factor among many that influences the risk of depression.

Biology is another factor. Following the Christian faith does not change risk factors such as a family history of depression, past episodes of depression, substance use, trauma or medical illness. Being a Christian also does not change the biology of depression, which recent research has shown involves changes in activation levels and communication between specific brain regions (see Len’s article, “The Most Important New Findings in Depression” for more details).

I believe the most substantial reason Christians do not have less depression than the general population is due to stigma. Stigma results in fear, shame, hiding problems and not accessing treatments that alleviate depression.

In 2014, LifeWay Research prescreened 800,000 Protestant Christians and, based on the results, surveyed 1,000 pastors, 355 Protestant individuals with acute mental illness and 207 Protestant family members of those with acute mental illness. The findings from the survey revealed the substantial impact of mental health stigma. Their research showed that:

• 65% of family members believe local churches should talk more openly about mental illness to reduce stigma

• 20% of individuals believe that their acute mental illness makes it difficult to understand salvation

• 49% of pastors report that they rarely or never speak about acute mental illness to their church in sermons or large groups

• 23% of pastors have personally struggled with mental illness

Addressing stigma in the church will help Christians more effectively deal with depression, which could dramatically lower the number of Christians suffering from depression.

Pastors may not be aware that members of their congregation might be waiting for them to proactively grant them permission to seek effective mental health care. Being silent on the topic of depression intensifies stigma, so at least a portion of each congregation needs the clergy to actively address the topic of depression and encourage professional treatment.

We can address mental health stigma in Christianity

Many factors may reduce mental health stigma in churches. I attend a small church, Headwaters Covenant Church, in Helena, Montana. Our pastor and leadership have addressed mental health stigma as part of a natural expression of our Christian faith. At our church we have:

• Participated in and cleaned up a local park after the annual NAMI Walk, which is an event to decrease mental health stigma led by our Montana chapter of the National Alliance on Mental Illness

• Had sermon series on wrestling with faith and mental illness

• Hosted a training on suicide prevention and invited our community to attend

• Had a “Conversation at the Well” series in which the pastor has interviewed church members during a worship service about their faith and Christian walk. My wife and I participated on separate Sundays. We shared how we felt called to specialize in psychiatry following medical school and how our faith impacts our medical practice. Other church members shared their personal struggles, and several shared their experiences with depression.

Having openly addressed mental health issues and actively supported mental health organizations in our community, our church members feel more comfortable sharing struggles with depression with no more stigma than discussing having diabetes or asthma. There are other approaches that churches can use to address mental health stigma, including:

• Small groups studies on depression and faith

• Clear communication from the pastor and leadership that depression and emotional pain are real

• Eliminating the unhelpful and incorrect message that most depression is caused by undiscovered or undisclosed sin. Yes, it is always important to pray. However, it also is important to get a depressed person to a highly competent professional. Secular depression treatments work effectively for Christians with depression.

• Direct encouragement by ministry leaders and counselors that having depression is not someone’s fault but it is their responsibility to take real steps to deal with it

• Sharing books for the layperson with depression that meet the definition of bibliotherapy (shown by research to decrease depression and/or suicide)

• Decreasing the expectation that a Christian can work only with a self-identified Christian counselor or psychiatrist

This is more important now than ever

The current pandemic has been harmful in so many ways. One problem that is top in my mind is the dramatic increases in anxiety, depression and associated suicide. It is alarming that the depression rate tripled in the US at the start of the 2020 pandemic (Ettman, et al. JAMA Network Open. 2020). America often looks to religion in times of national stress. The pandemic has been a catastrophic event for our nation. It is at this time that churches can offer greater support to their members who are likely also struggling with higher rates of depression and send the message to our communities that we can support them in their faith and other life struggles.

Things can get better for Christians with depression

While it is true that many Christians have depression, they can see improvement and full freedom from depression with the right support and interventions. The help and encouragement that they need can start with their church communities. All churches can take simple steps to reduce stigma and help their congregations. Acknowledging that depression is real, that help is available and that church members are permitted and encouraged to seek effective treatments might be all the support that some people need to get help. However, many other Christians need much more help to address the shame and guilt that they have over experiencing depression in the first place. The church can be the first place that depressed Christians lean on for support and can become the most effective means to help Christians to achieve full freedom from depression.

For further reading, check out:

• Len’s Article, “A Note to the Suicidal Christian”

• Len’s Article, “Your Safety Plan for Suicide Prevention”

• Len’s Article, “Never Delay Dealing with Depression”

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