Spirituality and mental health: challenges and opportunities
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Spirituality encompasses connection—religious or otherwise—with a non-physical reality as perceived by the individual. Sigmund Freud famously considered this domain a form of neurosis. Spirituality remains at the side lines of mental health science to this day. Private and philanthropic foundations are the largest supporters of research on spirituality and mental health. No other social phenomenon is so widespread, yet all but ignored by academic psychiatry.

Spirituality is clearly related to mental health in both positive and negative ways. On the positive side, various aspects of spirituality to fewer symptoms of depression, a lower incidence of suicide, and lower severity of alcohol or substance use.

Spirituality can also promote emotional wellness, as evidenced by its associations with greater life satisfaction, self-esteem, higher levels of marital and family functioning, and better adjustment to clinical concerns. In one study of nearly 90000 American women, weekly religious service attendance predicted a five-times reduction in suicide, even after controlling for depression, major life stressors, and social activity.

However, not all facets of spirituality are salutary. Spirituality can co-opt the presentation of psychotic and obsessive symptoms, complicating treatment. Worse, spiritual struggles (eg, disillusionment with organised religion following clergy sexual abuse scandals, anger towards God) can functionally contribute to emotional distress. In one study, more than 40% of pre-treatment suicidality could be accounted for by spiritual struggles, particularly those relating to God.

For these reasons, spiritual themes often arise in clinical care. Although it remains controversial as to whether spiritual components of Alcoholics Anonymous and other 12-step approaches are intrinsic to their efficacy, they are the most common treatment pathway for drug and alcohol problems, and are associated with more than half (54·3%) of all reported recoveries.

In terms of challenges, relationships between spirituality and mental health are bidirectional and complex, as positive and negative effects can be present for any given person. We have to acknowledge that most individuals are spiritual, use spirituality to cope with distress, and wish to address spirituality in treatment. Spirituality could therefore play a pivotal role in disseminating evidence-based treatments, while providing new vistas to enhance our understanding of the human condition.

Source: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30048-1/fulltext