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July 14, 2010

Should mental health care include religion?

Prof. Dr. Mohamed Elmasry

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I was shocked to read the advertised claims of a certain pill that "ends depression and anxiety in less than 15 minutes."

Equally alarming is the study published by the New England Journal of Medicine in its January 2008 issue, which reveals how 88 per cent of clinical trials which showed that 12 widely-circulated antidepressants did not work, either were not published in medical journals, or were presented as positive findings.

The cited study, led by Prof. Erick Turner of the Oregon Health and Science University, provides the first hard data on a problematic practice known as "selective reporting," in which the good news about a drug is made public, but the bad news is not.

There is no current study to suggest that the percentage of Canadian Muslims who suffer from depression is any higher or lower than that of the general public.

But as a provider of pastoral counseling and spiritual guidance, I know the pain a person can go through and I also know how difficult it can be to successfully refer the sufferer to a health care professional.

Depression is a medical and psychological condition that can moderately to severely impair a person’s ability to function in everyday life.

Scientific and other professional surveys report that every year almost 10 per cent of American adults aged 18 and older experience some form or degree of depression. Other Western nations, including Canada, are not far behind.

The symptoms of depression include feelings of hopelessness, worthlessness, anxiety, guilt, or helplessness; prolonged periods of fatigue and decreased energy, often along with insomnia or oversleeping; loss of interest or pleasure in activities that were once enjoyed (including sex); increased difficulty concentrating, remembering things, or making decisions; appetite and/or weight changes; and thoughts of suicide, or suicide attempts.

Although therapeutic intervention - which requires time, commitment and expertise -- can alleviate symptoms in more than 80 per cent of those receiving treatment, less than half of those suffering with depression get the appropriate help, or get help when they most urgently need it.

Many patients and their doctors find it easier and faster to rely only on medication to alleviate symptoms, but in most cases this is a short-term "quick-fix" that may mask deeper and even life-threatening problems.

There are indications suggesting that highly industrialized and technologically complex Western countries have higher rates of mental illness than traditional societies such as those found among Arab, East Asian, African and various Pacific Island groups.

Perhaps factors such as lifestyle, diet, environment, stress levels, and extended family dynamics play a significant cumulative role in an individual’s wholistic health.

A British study indicates that an alarming number of English men suffer mental health problems, but most have been brought up in the emotionally minimalist stiff-upper-lip tradition and are too "macho" to seek treatment. The study suggests more outreach work is needed among men to destigmatize mental health problems.

There is hopeful news in empirical data showing a strong correlation between physical and mental health and faith, prayers, and religious practice.

Four medical researchers (Mark Townsend, MD et al) with the Department of Medicine at Virginia Commonwealth University in Vermont rigorously reviewed more than three decades of medical research literature (published from 1963 - 1999) about the effects of religion on health.

They set very stringent standards to select which articles or studies would be included in their detailed review and each one was read independently by all four researchers.

One study concluded that Islamic-based psychotherapy speeds recovery from anxiety and depression in Muslims. Another study indicated that religious beliefs and activities appear to improve blood pressure, immune system functioning, and life expectancy.

Yet another study shows that Christian intercessory prayer appears to improve health and survival outcomes in patients admitted to coronary care units and also may improve survival rates in children with leukemia.

The Virginia Commonwealth University study group’s own findings include:

private prayer may be associated with decreased depression after coronary artery bypass surgery among married men; religious activity may be associated with decreased depression among African Americans with cancer; religious involvement may be linked to fewer depression symptoms among older Dutch men; religiosity may limit stressors in already depressed patients; and ongoing religious commitment may protect against depression among retired Roman Catholic nuns.

And a very important conclusion was: "Religion may also have a protective effect against suicide."

The Vermont researchers concluded that the vast majority of Americans consider religion to be an important part of their lives and want health care providers to address religious issues.

They conclude also that "involvement in religion or religious activities may promote mental and physical health" and this includes, "positive social and interpersonal functions, affirmation of shared beliefs, improving coping skills, resolution of guilt, diminished fear of punishment [and] the threat of embarrassment..."

They end with a very important recommendation: "Considering that patients think religion is important, that religion likely benefits health outcomes, and that religion is without financial cost, health care providers should include religion in the care of their patients."

It seems we have been largely ignoring the "best medicine" of all.

Any takers?

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