Sunday morning after church service, Deacon Johnson was on his way out and getting ready to watch the Washington Redskins football game. He bumped into Miss Watson and warmly asked her, "How are you feeling this fine Sunday morning?" Miss Watson had recently suffered terrible losses, because she unexpectedly lost her job and her mother died two weeks ago. Miss Watson forced a half-smile, lifted her shoulders back, and responded "I'm too blessed to be stressed!" Although Deacon Johnson nodded in approval, he did not fully believe Miss Watson's response. Overhearing this conversation transformed my professional career.
"I'm too blessed to be stressed."
"I'm too blessed to be stressed" is repeated by people of faith like a badge of
honor. The reality is that we are all stressed. We work long hours, battle traffic, and try hard to find that special soul mate. We raise children, care for aging parents, and worry how to pay our bills on time. If stressful situations continue, a person is at a higher risk of suffering from major depression. In fact, major depression is now the no. 1 cause of disability in the world.
As an African American, Christian, psychiatrist on faculty at Columbia University Medical Center, I know that churches are often the first place people go when struggling emotionally. Studies show that more people first seek help from a pastor during an emotional crisis than any other health professional. Pastors provide counseling and can make referrals to mental health specialists. Unfortunately, stigma and the fear of mental illness causes people in the church to suffer in silence instead of seeking treatment. Distrust of mental health professionals is especially strong in communities of color, as African Americans and Latinos have the lowest rates of depression treatment in the United States.
Imagine that we could create church environments where people felt safe to acknowledge their struggles with stress, depression, or substance use - instead of insisting that we are "too blessed to be stressed" - we could encourage people to seek care when it is needed.
A recent study that I published in the American Journal of Preventive Medicine showed how three churches in New York City identified people at risk for depression. In the study, 122 people completed an anonymous survey. The survey asked 9 questions about whether a person experienced sad or depressed mood, inability to enjoy pleasurable activities, difficulty falling asleep, feelings of guilt or worthlessness, fatigue, difficulty concentrating, appetite changes, and thoughts of death / suicide in the previous two weeks. The survey was scored from 0 (no symptoms) to 27 (severe symptoms). People who scored 10 or higher on the survey were classified as having a "positive depression screen."
Our results showed that people who attend church are stressed. We found that 1 out of 5 people had a positive depression screen, which is double the rate found in community samples. Importantly, we found that more men (22.5%) screened positive compared to women (17.7%). Our ability to identify a high percentage of depressed men suggests that churches are important entry points for engaging men in mental health treatment.
Faith communities are at a crossroads, and a movement is growing to create caring congregations in every church in the U.S. Rick and Kay Warren recently hosted a conference titled "The Gathering on Mental Health and the Church ." Over 3,000 people attended this conference in which faith leaders, policy leaders, scientists, and mental health professionals disseminated information and resources. Building on this conference, I believe that caring congregations responds to their parishioners with the following messages:
1. Depression is a common, disabling illness for which there is effective treatment
2. Depression is not due to weakness, sin, or lack of faith
3. Coping strategies to reduce stress include faith practices (i.e., prayer), regular exercise, a healthy diet, talk therapy, and medications as needed.
What can you do next? If you are suffering from stress and depression, visit www.nami.org or www.psychologytoday.com for resources and providers in your area. As community members, you can speak with your church leaders or employer about the importance of promoting mental health. Pastors can speak about mental health from the pulpit and have workshops at your church. I would love to hear your other thoughts and suggestions!
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