More depressing news

March 7, 2008 | 117 comments
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Today’s news carries a deja vu article: Surveys show high rates of depression in Utah, and some psychiatrists wonder if Mormon culture is part of the cause. (The story runs under a pretty direct illustration that shows an apparently depressed woman and a photo of the temple in the background.)

The article discusses two recent surveys:

The postcard image of Utah is a state of gleaming cities, majestic mountains and persistently smiling people. But new research shows a very different picture of the state, a snapshot of suicide and widespread depression.

A recent study by Mental Health America, the country’s oldest independent mental health advocacy organization, ranked Utah the most depressed state in the country.

Another survey released last week by drug distribution company Express Scripts found that residents of Utah were prescribed antidepressant drugs more than those of any other state and at twice the national average.

According to MHA, some 10.14 percent of adults in Utah “experienced a depressive episode in the past year and 14.15 percent experienced serious psychological distress. … Individuals in Utah reported having on average 3.27 poor mental health days in the past 30 days.”

The reason for Utah’s mass depression, however, is unknown.

“The truth is, we don’t know why,” said Dr. Ted Wander, spokesman for the Utah Psychiatric Association.

It focuses in particular on Mormon women, leading off with one anecdote about a depressed woman, and suggesting that depression rates among Mormon women are probably high. The article’s suggestions about links between Mormon culture and depression are particularly interesting:

Psychiatrists point to several factors that could contribute to Utah’s high levels of depression: limited mental health resources, restricted access to treatment as a result of cost, poor quality of resources and a varied list of other factors, including an underfunded educational system and a culture deeply rooted in the Mormon faith.

“Availability to resources, a lack of professionals and barriers to treatment, including the ability to pay all drive up instances of depression,” said Dr. Curtis Canning, a Logan-based psychiatrist and former president of the Utah Psychiatric Association. “But there is also — especially when it comes to women and girls — a cultural factor.”

Seventy percent of Utah’s residents are Mormon. When Express Scripts issued its first national survey of prescription drug use in 2002, it sparked a heated debate across Utah about what, if any role, the church played in the state’s high dependence on antidepressants such as Prozac and Zoloft.

“In Mormon culture females are supposed accept a calling. They are to be constantly smiling over their family of five. They are supposed to take supper across the street to an ill neighbor and then put up with their husband when he comes home from work and smile about it the whole time. There is this sense that Mrs. Jones down street is doing the same thing, and there is this undercurrent of competition. To be a good mother and wife, women have to put on this mask of perfection. They can’t show their tears, depression or agony,” Canning said.

“Obedience, conformity and maintaining a sense of harmony” are unspoken but widely recognized behaviors, which all contribute to what he calls “the Mother of Zion syndrome.”

The article also quotes an LDS family services spokesman who argues that church culture isn’t any more likely than any other to foster depression:

The Church of Jesus Christ of Latter Days Saints, however, says the high number of prescriptions is a result of people receiving the drugs they need in Utah more than in other places.

“I don’t think it’s clear that there’s a crisis in Utah,” said Brent Scharman, a psychologist and the assistant commissioner of LDS Family Services, a church network that provides counseling. “You’ve got one camp that says there is more depression and another camp that says we just have more consumers.” Scharman said studies on organized religion and depression found that religious people were generally happier than nonreligious people, and that held true for Mormons.

“It always boils down to the issue of what influence the LDS lifestyle has on the depression phenomenon,” he said. “Non-LDS and some LDS people say this is a kind of driven lifestyle and that we push too hard and smile too much. But studies show, and those living it out see, that religion is good support. It creates a positive network and helps people get through crises and deal with long-term problems.

“Are there people who feel ‘I’m not living up to the LDS ideal,’ or ‘I’m not living up to my family’s expectations’? Absolutely, there is no question. But having done counseling outside the LDS community, I saw people there, too, who were depressed because of perfectionism,” he said. “I wouldn’t say it is any worse here than in more diverse communities.”

What do readers think? Does it seem that church culture is linked to depression (particularly among women)? If so, what are the factors that create this effect? And more importantly, what can we do, as individuals or the church as an institution, to limit cases of depression, and to help depressed individuals find peace?

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117 Responses to More depressing news

  1. E on March 7, 2008 at 6:07 pm

    This really interests me because I treat a lot of depressed people as a physician in Utah. Utah and other western states also have a higher rate of suicide than other areas of the country. This sort of almost cliched portrayal of depressed Mormon women is, I think, really not very reflective of reality in this area. The problem with blaming LDS culture is that evidence does not suggest that LDS people in Utah have higher rates of depression than non-LDS in Utah. Active LDS actually seem to have lower rates of suicide than other groups in the western US. I think these statistics are a mystery that has not been solved, and I think the easy “it must be because life is too hard in the LDS church” prevents serious investigation into the undoubtedly complex situation.

  2. Clark on March 7, 2008 at 6:08 pm

    The prescription drug use survey isn’t a good pointer on depression. The MHA study is more interesting but Channel 4 being Channel 4 it doesn’t really tell you much about that. I found the study and given what it correlates problems with it’s probably access to mental health resources that causes a lot of the problems.

  3. Clark on March 7, 2008 at 6:10 pm

    I’d add that if you check out its chart (at the bottom) there’s obviously a regional issue going on as well.

  4. Brian Duffin on March 7, 2008 at 6:12 pm

    I tried reading the article, but I was too depressed to finish. Darn it!

  5. Dan Ellsworth on March 7, 2008 at 6:21 pm

    The Church of Jesus Christ of Latter Days Saints, however, says the high number of prescriptions is a result of people receiving the drugs they need in Utah more than in other places.

    “I don’t think it’s clear that there’s a crisis in Utah,” said Brent Scharman, a psychologist and the assistant commissioner of LDS Family Services, a church network that provides counseling. “You’ve got one camp that says there is more depression and another camp that says we just have more consumers.”

    More consumers? As in, there are more people to consume the drugs? More at-risk people? Did he say that with a straight face?
    I would have been much more comfortable with a straightforward answer like: “It’s clear this is a problem among our people, and we are working on ways to address it.”

  6. Chris Bigelow on March 7, 2008 at 6:22 pm

    I personally believe the main reason Mormons take more antidepressants is because we don’t turn as much to vices like alcohol and pornography to self-medicate ourselves when we’re feeling down. But antidepressants are legit, so more of us flock to those. We’re probably overall less depressed than other people, but when we are depressed, we have fewer alternatives for treating it and so our depression rates get onto the radar. Of course, the self-medications that the world uses to alleviate depression only cover symptoms and often lead to deeper problems.

  7. Ray on March 7, 2008 at 6:33 pm

    #5 – Whether or not the answer is “correct”, it is as straightforward as it gets. “We aren’t depressed more; we use anti-depressants more.” How can it get more straightforward than that?

  8. Doc on March 7, 2008 at 6:35 pm

    That’s it, I see this this one more time and my head is going to explode. Please read my answer to any and all people wanting to know if Mormonism and depression are linked.

  9. Ray on March 7, 2008 at 6:36 pm

    BTW, I do think there are elements of the common perception of perfection that contribute to depression among us, but I don’t think our percent of clinically depressed people is higher than the national average. I think we need to re-address how we view perfection and repentance to bring these concepts more in line with how they are treated in our scriptures, so I agree we need to use these studies as a motivation for introspection and change, but to extrapolate simply that “Mormons are more depressed than anyone else, and it’s the Church’s fault” simply isn’t supported by the big picture.

  10. Ray on March 7, 2008 at 6:40 pm

    Well said, Doc. It’s hard for many to admit we are human – and that needing and getting help is not a bad thing. The underlying assumption of these studies is that, somehow, using anti-depressants is a bad thing. That is perhaps the most depressing aspect of these studies.

  11. E on March 7, 2008 at 6:45 pm

    Thanks, Doc.

  12. Christian on March 7, 2008 at 7:03 pm

    The LDS church is the only religious organization that I know of that actually tells its members to take medication if the physician recommends it. Other religions and cultures tend to have strong taboos against accepting psychiatric care and particularly medication. I suspect that the world outside of Uta is generally underdiagnosed and undermedicated for depression.

    Living in downtown Las Vegas, I almost every day see at least one person talking angrily to themselves while crossing the street. I know that’s not depression, but it’s a pretty big piece of evidence to me that Utah, where I lived last, didn’t have so many mentally ill people as some lefties would have us believe.

  13. Christian on March 7, 2008 at 7:04 pm

    “I would have been much more comfortable with a straightforward answer like: “It’s clear this is a problem among our people, and we are working on ways to address it.” ”

    Let’s get this straight — you see the fact that more people in Utah are getting treated and medicated for Depression than in other states as a “problem” that the church needs to “address”?

    That’s nuts.

  14. Jeremy on March 7, 2008 at 7:31 pm

    I don’t think any study of depression can be taken seriously unless it controls for this variable.

  15. Carol F. on March 7, 2008 at 7:36 pm

    Whether or not the statistics point to an LDS problem or not, the fact that any LDS are taking medication to manage depression is difficult for some to understand. I had never thought of it before she pointed it out, but a friend of mine who grew up LDS and “self-medicates” with occasional alcohol finds it difficult to be judged so harshly in the church while watching others perpetually medicate using drugs. It is an interesting and valid perspective.

  16. Doc on March 7, 2008 at 7:53 pm

    Jeremy (#14),
    ROFL, that is classic. This is a prime example about why association does not mean causation, and biting critique of the way the media handles depression. I like it!

  17. Ray on March 7, 2008 at 7:59 pm

    Carol, no it’s not. It’s interesting, but it is not valid. Depression is, to a large degree, for many people, a physiological disability – one that can be moderated only through administering changes to the body. Your friend is discussing two approaches:

    One is using a generic drug (alcohol) to cover one’s problems by ignoring and suppressing them, while the other is using targeted drugs (prescribed by someone who, hopefully, has a better understanding of the big picture) to alleviate and address the actual condition that causes the depression. Alcohol causes multiple other issues, particularly since it is being self-administered. It’s like using a shotgun to kill a fly without considering what else it being killed in the process. The difference is simple and clear and important.

    As gently as I can say this, your friend’s concern comes across as an attempt to justify her choice of drug rather than an attempt to deal properly with whatever is causing her to drink. If I were you, I would suggest to her that she should let someone who can address the actual symptoms help her. “Self-medicating” is rarely a good idea; it’s much better to use prescribed drugs (in the vast majority of cases addressing depression) than it is to try to drink away the depression – for many reasons.

    To those who cannot understand why Mormons would (**should**) use prescription drugs, I would say, “Depression is a natural result of the Fall – of mortality – for many. We are commanded to overcome the natural (wo)man. We are NOT commanded to do it on our own, as individuals, without the help of medical advances. Why would we not use those advances?”

    My friend was diagnosed with leukemia last year. Almost everyone would call her completely stupid if she refused the chemo and other treatment medicine now can provide. Depression is NO different; not a bit. Anyone who chastises someone for using anti-depressants just doesn’t get it.

  18. adcama on March 7, 2008 at 8:15 pm

    Interesting article. It’s weird to me that some of the comments seem to be almost defensive. Isn’t it a better approach to acknowledge that there may be something going on (based on multiple studies with similar findings), try to identify the root causes and work toward some sort of remedy?

    Certainly we can’t just sit back condemning the studies (note plural), blaming conclusions on everyone else (our people just get help more) and keeping our heads in the sand?

    We do have much to offer as a community – and we constantly push for Christlike excellence, but maybe we need to fix something here, no?

  19. Jesse Harris on March 7, 2008 at 8:18 pm

    It’s worth noting that Utah isn’t exactly the most diverse pool of DNA in the country. Couldn’t it be possible that some pioneer family had the depression gene and it spread like wildfire?

  20. Jim Cobabe on March 7, 2008 at 8:24 pm

    Hmm…

    Haven’t used too many prescription drugs lately, but I don’t recall any pharmacist ever asking for my temple recommend.

  21. Ray on March 7, 2008 at 8:29 pm

    adcama, there is a huge difference between “defensive” and being bothered by the implication that taking anti-depressants is a bad thing – which is the underlying tone of the article about the studies. I would rather focus on the issue identified in #2 (access to mental health resources) and on getting even more diagnoses than on stigmatizing the use of these drugs.

    Again, fwiw, I agree we need to use these studies to examine ways to reduce depression without the use of prescription drugs (re-read #9), but if the only way to do so is to lower our aim and accept theological mediocrity, I’m not a supporter. This is true especially since, as E says in #1, “The problem with blaming LDS culture is that evidence does not suggest that LDS people in Utah have higher rates of depression than non-LDS in Utah. Active LDS actually seem to have lower rates of suicide than other groups in the western US.” That’s true of every study I have seen, and pointing that out is not defensive. It simply is correcting an incorrect assumption.

  22. Mark B. on March 7, 2008 at 8:29 pm

    I grew up in Utah, and I don’t remember my mother spending long hours despondent about not being permitted to be crabby. Given the challenges that life threw her way (especially the four of us children), she could have been crabby a lot, I suppose, and maybe she took it out on the dog while we were at school. Nonetheless, I remember her as relatively well-adjusted, not worried about being a smiling perfect Mormon mother, and anxiously engaged in doing good to her family and her community. So, where is this myth that Dr. Canning exposes? Has it only arisen since I left town (in 1977)? Or is it limited to people in certain exclusive neighborhoods?

    Having seen my wife in action outside of Utah for these past 31 years, I think she’s been about as crabby as she has wanted to be, and doesn’t keep it all locked up inside, to be relieved only by the daily dose of Prozac. She does smile regularly, and hasn’t seen fit to dispatch me to my eternal reward yet, although that might just increase the regularity of her smiles.

  23. Christian on March 7, 2008 at 8:31 pm

    “maybe we need to fix something here, no?”

    last I checked, medication and treating sick people is “fixing something.”

    I don’t see the fact that more people in Utah are getting treated and medicated for depression than in other states as a “problem,” and your shallow reply that those who disagree with you are defensive and unchristlike, seems to skirt the point. If you’ve got any evidence that there’s something to fix, please bring it up.

  24. aloysiusmiller on March 7, 2008 at 8:33 pm

    More bull …

  25. Anon on March 7, 2008 at 8:42 pm

    It\’s sad that this article takes as a given that anti-depressant use is a bad thing. So Utah chooses Zoloft and Prozac over Jim Bean and Jack Daniels. And the problem is….?? Couldn\’t this mean that Utahans are more open with their depression? I think that would be a good thing.

    I think life is getting tougher – everywhere in the US. People have to work two or three jobs just own a home. Teens have to jump through crazy hoops to get into college. New levels of access to information put the world\’s problems at our doorsteps every day. Combine this with a healthy dose of Mormon \”set-apartness\”, and Utahans are going to get depressed. We never have claimed to be less human than anyone else.

    IMO, this is just an example of the rest of the nation pointing out the mote in Utah\’s eye.

  26. SSCenter on March 7, 2008 at 8:45 pm

    Jesse let me comment that your statement was deeply offensive. If anything there would be much less of this narrowing of the gene pool as Utah has always had a huge influx of new people coming to it for 150 years. I was always taught that we see in others what we most dislike about ourselves.

  27. Mark N. on March 7, 2008 at 8:58 pm

    Maybe we’re all depressed because we keep seeing glimpses of Zion in 4th Nephi and the PofGP, and at the same time we’re stuck with this rapidly degenerating society that believes the answer to everything is money.

    If that doesn’t get you depressed, nothing will.

  28. Ardis Parshall on March 7, 2008 at 8:59 pm

    SSCenter, Jesse’s comment was not at all out of line. I’m guessing you read it as an accusation of inbreeding. Here’s an alternate, inoffensive interpretation:

    Geneticists like working in Utah and with Mormons because our genealogical records assist them so well. In fact, there *was* a Mormon immigrant from Scandinavia who brought with him a mutant gene that causes the heart to stop when a carrier suffers a blow to the chest (Long QT Syndrome? something like that). It kills seemingly healthy young people engaged in sports. The Mormon immigrant passed that gene on to his descendants, and geneticists were able to trace its progress through generations, and warn living generations so that they can take precautions. The defect is particularly common in Utah because the immigrant has such a large posterity, so many of whom still live here. No inbreeding about it, just the passing along of a certain gene to an exceptionally large number of descendants.

    I’m sure that’s all Jesse had in mind, that *if* genes play a role in some types of depression, and *if* an immigrant had brought such a gene and passed it to his posterity, *might* that possibly contribute to some significant number of depression cases? This is a vastly different hypothesis than inbreeding.

    [Later: Yes, it's "long QT syndrome." See this New York Times article for details about the heart condition and the Mormon connection.]

  29. Eric Russell on March 7, 2008 at 9:12 pm

    There are many studies, as articles such as this demonstrate, that show that the situation is much more complex than anyone seems to want to acknowledge.

  30. Anon 2 on March 7, 2008 at 9:17 pm

    The move to our current home (not in UT and not from UT) was very, very difficult. I had some health problems (not mental). My grandparents were on their deathbeds. We were thinking of suing someone who broke a contract in a big way. Then one afternoon I spent hours shoveling snow. In the middle of that, I got a phone call about a death in the family. About an hour later I had a huge panic attack. Never having had anything like that, I was very worried. My neighbor called the paramedics. They were very helpful. They told me what it was and what to do for it. (Breathe into a paper bag.)

    Now the reason I’m sharing this story. Their parting shot was, “You need a glass of wine.” The knee-jerk response outside of Mormon culture really was self medication. (Surprise!)

    As a matter of fact, I didn’t need a glass of wine: (a) It is against my religious principles, (b) I have an inherited liver condition that would be extremely worsened by alcohol, (c) I could have been pregnant or trying to get pregnant, and (d) alcohol is a depressant. Just what I need! (Right.)

    I agree with the point that rates of medication use does not equal rates of mental disorders. (Duh.)

    But it sure makes a sensational news story, particularly if you can blame it on the Mormons.

  31. Christian on March 7, 2008 at 9:19 pm

    “isn’t exactly the most diverse pool of DNA” isn’t exactly the most articulate way to express the concept that you just describe, Ardis. I agree with you that it’s a viable theory, and I agree with SSCenter that the way that Jesse worded it was very offensive, suggesting inbreeding. Utah does have a diverse pool of DNA given the higher than average number of immigrants, but does, like you say, have certain men with many many descendants in the state. If that’s really what Jesse had in mind, then we should remember in the future to rely on your gift of interpretation of Jesse.

  32. Marcia on March 7, 2008 at 9:43 pm

    I think there is a range of factors at play that lead to a high incidence of depression among Mormon women; hormonal fluctuations after childbirth, isolation, genetic pre-disposition, distorted self-comparison and the devil fighting against them visciously. All of those factors to some degree have contributed to my depression.

    I descend from my sad English fathers who tried to find happiness in a mug of beer and Mothers who left their drunken husbands and found the gospel.

    The Lord hasn’t promised unending happiness and bliss in this life.

    Nephi lived after a “manner” of happiness and mourned out his days.

    I have been able to learn life learn life lessons from my depression that I could not have learned without it.

    :) I ‘m glad the Lord has provided seratonin uptake drugs as a form of relief for my chemical instabilities.

  33. Stephen M (Ethesis) on March 7, 2008 at 9:53 pm

    No, there is something going on in the mountain states and other places where daylight is foreshortened. That LDS depression rates are lower than the non-LDS in those areas is often missed, and missing that obscures that there is a real issue that is being missed by those interested in a quick news story and not in the reality.

  34. Velikiye Kniaz on March 7, 2008 at 10:03 pm

    Personally, I’m convinced it is the green Jell-o, and all it’s attendant variations…

  35. Matt Evans on March 7, 2008 at 10:23 pm

    I’m confused by the summary —

    Psychiatrists point to several factors that could contribute to Utah’s high levels of depression: limited mental health resources, restricted access to treatment as a result of cost, poor quality of resources

    and

    residents of Utah were prescribed antidepressant drugs more than those of any other state and at twice the national average

    So which is it: (1) Utahns have restricted access to mental health treatment, or (2) Utahns receive twice as much mental health treatment as the rest of the country?

  36. Matt W. on March 7, 2008 at 10:24 pm

    anecdotally, I feel more depressed in Utah, it’s because of the mountains blocking out light. I think it’s like Seasonal Affective Disorder. According to 1 study 10 to 20% of the population may have SAD…

    Further, the reason the article focuses on women is women are more likely to be depressed to begin with.

  37. adcama on March 7, 2008 at 10:26 pm

    Christian, I may be shallow, but why do you have to be such a meanie? I was just trying to tweak Ray – he’s always so positive it just pisses me off sometimes.

  38. Matt W. on March 7, 2008 at 10:28 pm

    In case anyone thinks I’m wacky on the mountain thing, keep in mind Colorado teens are the most depressed in the nation.

  39. Darrell on March 7, 2008 at 10:35 pm

    I think Matt in #36 may be on to something. Two years ago, I moved to the Columbia Gorge where, along with the over 100 inches of rain we get a year and the attendant cloudiness, some times of year the sun does not rise above the mountains until 10 am. I was immediately struck by how many people claimed to be bi-polar or were/are on anti-depression medication. This is in stark contrast to the people in the high desert of Eastern Washington where I moved from. The difference is amazing.

  40. Marcia on March 7, 2008 at 10:46 pm

    Seasonal Affective Disorder? There are far more sunny days in Utah than in states like Oregon and Washington. OK -compare the rates of depression of LDS women who live in Utah in the shadow of the mountain and those who live in the sunny valley.

  41. Ray on March 7, 2008 at 11:14 pm

    #37 – Love it, adcama. Absolutely love it. (Sorry; is that too positive? *grin*)

    Fwiw, this is such a soapbox issue for me because of my experiences growing up (my mother’s schizophrenia), studying at an intensely competitive college (with its attendant issues of pressure and depression), counseling women dealing with various depressive issues and trying to get members to look differently at perfection and repentance. There are things we can do to lessen the stress that contributes to depression, but being Mormon is not one of them.

    Teaching uplifting messages about divine potential – for men and women, teaching people to strive to be better than they naturally are, teaching people to follow the teachings of Jesus, ad infinitum – that is NOT a bad thing, especially if it leads people to accept medical help, to be better people and closer to what they want to be, to accept other people despite things that “the world” classifies as marginalizing disabilities, to allow those with expertise to serve others through that expertise, ad infinitum.

    Yeah, this is a soapbox issue for me, since I have spent decades trying to heal the wounds that misguided criticism and condemnation and unrealistic expectations cause.

    end of rant – back to being too positive *bigger grin*

  42. Ann on March 7, 2008 at 11:18 pm

    Matt Evans, you don’t have to be getting mental health treatment to have a prescription for an anti-depressant. A general practitioner can prescribe, and lots of people take meds alone with no additional treatment. So lack of access to good mental health care COULD cause higher usage of anti-depressants.

  43. Ryan on March 7, 2008 at 11:27 pm

    My wife came across this article on the LDS living magazine a few weeks ago. It is entitled \”Keeping the Magic Alive in Marriage.\”

    http://www.ldslivingmagazine.com/articles/show/1313

    I\’m sure the author had good intentions, but if this way of thinking is remotely representative of how some LDS women feel then I think this is an issue. Pay attention to the section in the article entitled \”Continue Growing and Evolving.\” Here is an excerpt from right at the end that could bring about a huge expectation gap for any person that thinks they have to be perfect:

    \”But every single husband on the planet (if he’s wise) wants a wife who is going for it. He wants to be proud of her. He wants to come home every day to hear of something new that she did or learned. He wants a wife he can brag about. You can be that wife. He already loves you. He also wants to be stimulated by your growing and changing and be interested in you. I know that someday you will be the perfect wife. In the meantime, may you be blessed on your path to get there.\”

    Needless to say my wife liked some of the suggestions for married couples (earlier in the article), but found the \”perfect wife\” and the expectations that her husband supposedly has to be a bit much. I\’d feel depressed if my wife felt the reverse about me. The expectations are supposed to be faithful to our covenants, repent often, strive to do a little better, and pick ourselves up when we don\’t. Perfection only comes through Christ.

    Oh, and for those wondering about Seasonal Affective Disorder, try Cleveland, OH. One of the grayest and overcast cities.

  44. Bob on March 7, 2008 at 11:36 pm

    I am sorry I didn’t get to this post sooner so I could be of help:
    1) It’s depressing to live in Utah.
    2)It’s depressing to be a Mormon living in Utah.
    3) It’s depressing to live NEXT to a Mormon in Utah.

  45. mlu on March 7, 2008 at 11:39 pm

    With proper medication, a broken heart and a contrite spirit may be a thing of the past.

  46. Bob on March 7, 2008 at 11:47 pm

    #28: Ardi, My people are from the Sanpete Valley and I am “as strong as a Swede”. But there may be something in what you say, my father said men Swedes don’t live to be old, they just fall over one day.

  47. Ray's Wife on March 7, 2008 at 11:49 pm

    #37 – adcama — Imagine being married to him… being surrounded by that never-ending positive attitude all the time. Sometimes it’s very frustrating; usually it is a real lifesaver!! ;-)

  48. Seth R. on March 7, 2008 at 11:52 pm

    Prozac (among other antidepressants) is a common drug treatment for ADHD as well as depression. Did the study take that into account?

  49. Stephanie on March 7, 2008 at 11:54 pm

    Has anyone looked at how maternity relates to depression in Utah? More women have babies in Utah than in other places, and postpartum depression is a real issue. Just the hormones related to pregnancy, delivery, and recovery can really throw you off. Or, the sheer exhaustion of having so many kids can take a toll. I am a happy LDS woman with four children, but I have had my share of \”down\” times when I have been chronically sleep deprived. And after my fourth child, I suffered from postpartum thyroiditis and went from being anxious to depressed. It was the wierdest thing for a \”normal\” person like me. I was full of rage at my husband and children and didn\’t know why. It taught me that when the chemicals in our body are off balance (as happens with childbirth), it can really throw everything off. I just wonder if anyone has looked at the depression in Utah from that angle. I definitely don\’t think the solution is \”have less children\”. I think the solution is that we women (and our husbands) need to watch our health carefully and take good care of ourselves. We should not \”run faster\” than we are able.

  50. mlu on March 7, 2008 at 11:55 pm

    #47 All the news is good.

    I believe that’s true, when you can see clearly enough. But we all have our adcama moments, which sometimes last a long time.

  51. Stephanie on March 7, 2008 at 11:56 pm

    Or, from another angle, Mother Theresa has said that depression is a rich man’s disease. Only rich men have time to think about themselves. I think that is interesting.

  52. Lorin on March 7, 2008 at 11:57 pm

    The linked article disturbs me both as a trained journalist and as an active member who is generally winning a life-long battle against clinical depression.

    Disturbing journalism because it disingenuously skirts the Journalism 101 principle that statistics can be incredibly misleading and are a poor BASIS for a story unless both the stats and the implications are well understood and known to be applicable. Saying that no one knows why more antidepressants are prescribed in Utah doesn\’t neutralize the fact that the story projects insidious charges about Mormonism based on something that may have other reasonable explanations. A classic case of creating the story rather than pursuing it. I\’m an editor and this raises multiple red flags.

    It\’s disturbing as an active member because church service was always a welcome reprieve from the self-obsessed belly-button gazing that depression causes. (It\’s not the other way around.) My high activity in the church is part of the solution, not part of the problem.

    The problem is that I reabsorb serotonin too quickly and I need help kick-starting the production process every morning. One pill a day goes a long way. Nothing on the bottle says anything about making me forget I belong to a \”depressing religion.\” Maybe they could use that in the next marketing campaign?

    I suggest the big problem in Utah is that we live on the wrong side of the mountains. My form of depression is strongly linked to a lack of sunlight in the morning, and 5 to 10 percent of the U.S. population have some degree of this problem without proper sunlight. I was diagnosed in the Midwest, where there are more clouds, but it\’s worse in more cloud-free Utah because the sun is behind the mountains to the east during the first two or three waking hours, the only time it can really turn on the photo receptors in your eye that trigger your brains production of serotonin. I have a light that takes care of that for me. Move the Wasatch Front to the west side of the valley and I\’ll be we cut depression in half.

    Nah, scratch that. We\’re just depressed because we\’re Mormons.

  53. Matt W. on March 7, 2008 at 11:58 pm

    Philadelphia is rated the saddest city in the US(Salt Lake is 12th Saddest), and El paso and Laredo, TX are the happiest.

    If anything this tells us that fajitas are better than cheese steak.

  54. Bob on March 8, 2008 at 12:00 am

    #47: Sooo…help the rest of the post out…what’s he on???

  55. Clark on March 8, 2008 at 12:03 am

    I’d second what Ann said (#42). And not just anti-depressants but also other drugs such as Aderol or Ridalin can be prescribed by general practitioners. Surprisingly most people I know on these did get the from a general MD. And that’s not a good thing for multiple reasons. Primarily that general practitioners don’t do the followup to check for side effects like they should. Second that they really aren’t trained in mental illnes. And finally that I think there is some evidence that the prescribe them way too easily.

    But turn to more robust mental health treatment and there’s (a) a lot of stigma and (b) not good insurance.

    I’d in one more thing. There is a lot of evidence that for mild depression (which is the majority) most anti-depressants have only a placebo effect. (There was a major study on this just a couple of weeks ago) It has a big effect of deep depression but let’s be honest. That’s not most depression. So if we are comparing Utah and non-Utahn populations one has to ask what the placebo effects are. Self-medication for all its problems may well activate the placebo effect and get people out of depression. If those placebos aren’t available for Mormons then what are their options? Get the placebo effect from Prozac I guess.

    Maybe if we convinced them that fine chocolate was the cure for depression we would achieve more. (Of course I’m biased there)

  56. JKS on March 8, 2008 at 12:12 am

    I know a lot of Mormon women. Some of them on or have been on anti-depressants. Many of them went on when they had post-partum depression.
    Mormon women have more children, therefore more likely to have post-partum depression in their life, or more episodes of it.
    Mormon women have children younger than average which means if they take anti-depression for childbirth related reasons, they do it younger, and then it means if they have subsequent episodes with depression they are more likely to recognize it and treat it with anti-depressants because they know whether or not it has helped them in the past.

  57. JKS on March 8, 2008 at 12:14 am

    I thought it had been proved that chocolate does cure depression, at least for a moment.

  58. Ardis Parshall on March 8, 2008 at 12:38 am

    I’d rather believe that it has NOT been proven yet, JKS — that way I can volunteer for the next clinical trials.

  59. Matt Evans on March 8, 2008 at 1:11 am

    Ann #42, what are the psychiatric depression therapies that Utahns may have limited access to?

  60. John Taber on March 8, 2008 at 1:20 am

    Carol #15:

    So I suppose you follow the Tom Cruise/Scientology line about the “evils of psychiatry” like so many other LDS? After all, Bruce McConkie likened psychiatry to the “church of the devil” in _Mormon Doctrine_.

  61. Jack on March 8, 2008 at 1:22 am

    mlu: “With proper medication, a broken heart and a contrite spirit may be a thing of the past.”

    Whoa. I’d like that. Nothing can bring on depression like the tyranny of being coerced into contrition (or out of one’s identity) in order to conform to a warped creedal version of pure religion.

    Stephanie: “Or, from another angle, Mother Theresa has said that depression is a rich man’s disease. Only rich men have time to think about themselves. I think that is interesting.”

    Though I think she’s right to some degree, what’s even more interesting is that no one suffered more from depression than Mother Teresa. And though most LDS are doing OK economically (comparatively speaking) I wouldn’t say they’re idle folk–with loads of time for navel gazing.

  62. aloysiusmiller on March 8, 2008 at 1:57 am

    Earlier I said more bull… I still believe that. The media nowadays contrives a lot of stories to fit some presupposition. Its tiresome. Its tiresome to see the knee jerk “oh it must be so here’s why” response to them. Its false from the very start and should be assumed so until it is proven otherwise.

  63. Clark on March 8, 2008 at 2:01 am

    Psychiatry still is a lot of bunk. But back in the 1950′s when Mormon Doctrine was written it was almost entirely bunk. At least know psychology and neurology has allowed them to state some positive things and treatments which are established scientifically. Which treatments of psycho-analysis were scientifically proven at the time of Mormon Doctrine?

    I’m not saying they were all quacks. Far from it. But it was very, very primitive at the time and there was a lot of grasping in the dark.

    The difference today is huge. As I said there’s a lot of science. But there’s no doubt a lot that isn’t as well.

  64. mlu on March 8, 2008 at 2:51 am

    #63 Yes, wheat and tares, with plenty of tares. I think it’s necessary to be constantly vigilant when it comes to theories and vocabularies offered up by the therapeutics. While I agree that things have gotten much better there is still a lot that derives from a human telos that doesn’t harmonize with the gospel view of humanity.

    In my work as a teacher, the worst trouble I see regularly stems from people whose morality and vocabulary for talking about the meaning of their lives comes from therapy. The persist in beliefs and practices sure to make them miserable, but they know no truth that might set them free.

    I especially cringe when I hear language imported from the therapeutics offered up from the pulpit. Use the old, scriptural words until you are sure you really understand them, I think.

    I’ve thought a lot about why the Savior requires a broken heart and a contrite spirit as the price of entry to his kingdom of joy. I’ve wrestled with depression, though “wrestled” seems too vivid and lively a word. But the thing that has amazed me in recent years is how unaccountably joyful my life has become, mostly through persevering in a far from perfect way with a lot of old homilies I was taught in church.

    Yes, there are organic problems that can be corrected with medication and these should be used. But if it were possible to find the proper chemical concoction that would keep us cheerful and happy no matter what, swallowing it would destroy our humanity. How would you feel if you went to a friend because something dreadful had just happened to you, but nothing you said could dent his or her good cheer and happiness?

  65. Doc on March 8, 2008 at 3:01 am

    Matt #59,
    I believe Ann might be referring to trained psychologists. Cognitive behavior therapy is a mainstay in the treatment of depression. The combination of antidepressants and cognitive behavioral therapy works better than either alone. Most Psychiatrists realize this, while general practitioners find it easier to just write out the prescriptions. Trained healthcare personnel are much rarer in the west in general. Mental health is likely doubly so, although I would have to check the numbers, which curiously are not cited in the article..

  66. Julie K on March 8, 2008 at 6:35 am

    #58 lol
    Ardis,
    Why not conduct your own clinical trial?
    Maybe Clark can help you out with your perscription.

    (And keep in mind that an ounce of prevention is worth a pound of cure!)

  67. Tatiana on March 8, 2008 at 9:13 am

    Mormonism helped cure my depression. There’s no getting around the chemical, physical components of the problem, and so antidepressants, and more importantly for me, lifestyle changes (the four pillars of mental health: good diet, good sleep, good exercise, and lots of sunlight) will always be part of the solution. However, it is through the LDS church that I learned who I am, (a child of God with a divine nature and inestimable worth). I learned the purpose of my existence (joy), and I learned how to achieve it, how to reduce the negative forces of sin and spiritual waste in my life, and realign my faculties and energies toward the positive, toward building up myself and those around me. I learned how faith and that perfect brightness of hope can conquer all my naysaying internal voices. I still forget sometimes and make mistakes, I sometimes fall back into the old ways, but overall I’m a much, much happier person since my conversion. Happier, more confident and secure, more at peace with myself and what I’m doing, and I’m having a lot more fun.

    Obviously, not everyone’s experience with Mormonism is like mine, but overall I know it does a lot more good than harm. The truth will set you free.

  68. Nate Oman on March 8, 2008 at 9:26 am

    I am skeptical that this study demonstrates a link between the Mormon culture of perfection among women (which is real and a bit freaky in my opinion; what is with the center pieces and seperate programs in RS?!?). Such a connection might or might not be real; it seems potentially plausible but I don’t see how this study could demonstrate it (particularlly as it doesn’t seem to have any actual data on Mormons; just data on Utahns). That said, I wouldn’t be surprised if there were different levels of medication use among Mormons, but for my money this is likely driven by two factors — lack of self-medication with alchohol and a unique demographic profile for the population.

  69. Barb on March 8, 2008 at 9:43 am

    Joining the LDS Church brought me such happiness at age 19. I had had depression/anxiety in my teen years prior to joing the LDS Church. I was very busy in my Young Single Adult Days with school, work, and callings and that was a wonderful time for me. I did not feel pressure to be perfect. I have never married or had children and as a single person and one who now has ocd manifest in a way that makes it hard for me to take care of myself and makes avoid a lot of contact with people and most especially the very young or the infirm, it makes me nervous to even think about. I should add that I think I was wired for ocd as even as a child I had a trait here or there such as a period of obsessively brushing my teeth for a brief period(not anxiety ridden brushing like my current obsessions). I don’t think the trauma in my life has helped me any there. But as I think of motherhood and demands on women, I think of two of my great gradnma who was Catholic and had 14 children(raised 13 to adulthood). Her son-in-law, my grandpa described her as a jolly woman. She did have a period where she had a breakdown and was hospitalized. I do not know why. All I know is that if she can be jolly with 14 children and those demands, I can’t imagine anything equal to that in what we are asked to do. I do beleive as my dad said that the older children were like “little mothers” to the younger children. With all my problems, I know that I have been so richly blessed with my membership in the LDS Church. I have had peace since being confirmed a member that I had only experienced in fleeting moments before. While I do not often enjoy the same level of closeness to God and the peace that I once had, I do have times when I feel such peace and also have felt strength from God on a daily basis. It may be hard to explain that I consider myself to be pretty happy much of the time when my ocd is below a certain threshold and I avoid activities that will tip me over the edge. I don’t take that for granted. It is a humbling trial. And I wonder with my depressive episode in high school prior to joining the LDS Church if I would have been a canidate for a mission now that the bar has been raised. I felt more strongly about going on a mission than anything I have ever done in my life. I felt God prepared me in ways as I felt his love at times that was so overwhelming that I thought I could never repay him. There were a few dark and painful years following my mission. However, that makes me all the more grateful for what I have now. I don’t have all the answers and I could be quick to rehearse bitter things in my mind as I sometimes do. I do so hope that I avoid that road and where it leads. I do not want to deny all the good that I have known and that I continue to know.

  70. Barb on March 8, 2008 at 10:14 am

    I have heard people say that some who abuse alchohol or other drugs are self-medicating. And as Nate says, that may account for Latter Day Saints taking anti-depressants. Of course, the difference is night and day in the two approaches. Taking anti-depressants does not give a person a buzz and can help a person function who might be bed ridden. Alchohol abuse or other drug abuse can make a person dysfunctional and effect family relationships and employment. Some drugs may make a person lose motivation or ambition(stoned).

    I know this is anecdotal but I want to share about two people I have known that were alchoholics. One was Protetestant and had a Education and Library Science degree with a minor in Spanish. I did not know of her problem until I was much older though I knew her all my life. I was told that when she was under the influence of alchohol that she was suicidal. In latter years, she took anti-depression medication. While I do not know if she ever stopped drinking even when her health was such that she should not drink, I do know that her husband could tell a difference in her mood with anti-depression medication. When she was more difficult to live with, it had a correlation with her being out of her anti-depression medication. I am not sure what caused her depression.

    Another person I know has abused alchohol and drugs. She also has been prescribed anti-depression drugs and valium. I don’t know if her alchohol abuse stopped when prescribed anti-depression medication. I think she went off anti-depression medication due to convulsions probably caused by prescribed medications and no alchohol was found in her blood at the time. She abuses alchohol and valium to this day. She is a borderline personality with self-esteem in the basement. It is so sad as she has no faith(raised without any religion) to draw upon. She has taken so many handfuls of drugs at times as cries for help that I think her body built up a lot of tolerence to valium and related drugs. I do think she had a point not to long ago where her vitals were dangerous. She also is a person who cuts. She is doing better now probably related to getting disability and not having to worry about finances or live with a man that would make her upset. It is a sad case. Most people who take anti-depressants probably do not fit her profile.

    Getting enough exercise is as effective to relieving depression as anti-depression medication in a study that I have heard. However, that is easier said than done. Maybe the link is why modern society being so sedentary is prone to depression though. Even those who note the link state that the severely depressed may need to start with anti-depression medication in the beginning.

  71. Dalene on March 8, 2008 at 10:45 am

    It’s not like any of this is old news. But I certainly have to hand it to this crowd. This is the very first time I’ve ever heard the excuse “Go blame it on the mountain.”

  72. bnielson on March 8, 2008 at 11:16 am

    This one is remarkably easy to explain. According to “The Case for Marriage”
    by Linda Waite and Maggie Gallagher, married women have statistically worse mental health and higher drepression than unmarried women. Does this mean marriage is bad for women as the family science profession believed for decades? No it doesn’t. Turns out if you reslice those statistics to factor for similar circumstances that married women actually have better mental health and less depression than unmarried women.

    The actual correlating factor to poor mental health in women was having young children. Now one can have young children as a married woman or as an unmarried woman, but one is more LIKELY to have them as a married woman. Thus we now understand why married women are more likely to have poor mental health than single women in a study that doesn’t factor in circumstances.

    And what do you think this might mean for a lame correlation to Mormonism and depression in women? You figure it out. :P

  73. Bob on March 8, 2008 at 11:37 am

    # 64: ” ..Use the old, scriptural words..” Do you mean: God said unto Moses..take ye these two tablets..

  74. Ivan Wolfe on March 8, 2008 at 11:48 am

    But if it were possible to find the proper chemical concoction that would keep us cheerful and happy no matter what, swallowing it would destroy our humanity

    Pshaw. There ain’t no Bottle in all the world like that dear little Bottle of mine. Better a gramme than a damn, I say. A gramme in time saves nine, and one cubic centimetre cures ten gloomy sentiments.

    There’s always soma. ;-)

  75. Jack on March 8, 2008 at 12:04 pm

    Bob,

    Ha! That’s great.

  76. Jack on March 8, 2008 at 12:19 pm

    Barb,

    You thoughts give me hope–please take my meaning: I’m one of those who is not likely to overcome all the effects of depression before I leave this life. And so, knowing that there are others–good folks like you–who struggle to live the gospel the best way they know how while battling depression helps me remember that I have a *real* problem. It’s so easy to forget that when a bit of sunshine comes through the window–instantly, I’m beating myself up for not exercizing enough faith, or not being loving enough, or obedient enough, or what-have-you.

  77. Ray on March 8, 2008 at 1:15 pm

    I wasn’t going to share this, since it is quite personal, but Barb’s and Jack’s comments prompted me to do so:

    One of the most memorable spiritual experiences of my life involved giving a blessing to someone who, unbeknown to me, had suffered from depression for many years. I won’t go into details of the blessing, but suffice it to say that I understood more clearly than ever before that conditions like depression are natural, that they are understood by deity in a very real way, that some people will not conquer them fully in this life and, most importantly, that the joy they will feel in the next life will far outweigh the pain and suffering they feel now. That can be small consolation in the depths of a depressive moment, but it is something onto which they can hold.

    Identifying a way to mitigate pain and suffering that cannot be conquered fully, in a way that does not carry other terribly destructive effects, should never be seen as a bad thing. In a very real way, it is participating in the healing of the marginalized that was the heart of Jesus’ ministry. That’s why studies like the ones cited in this post bother me so much – that they further stigmatize those who already are stigmatized unjustly.

  78. jrl on March 8, 2008 at 1:23 pm

    Ryan # 43- AMEN, brother…. AMEN!

  79. Bob on March 8, 2008 at 1:50 pm

    #77: I don’t think the study stigmatized persons, I think it stigmatized the Church and/or Utah (?)

  80. Ray on March 8, 2008 at 2:21 pm

    #79 – Categorizing anti-depressant use as a bad thing stigmatizes those that use them – not just the organization to which those who use them belong. The broad brush touches all within its strokes.

  81. Barb on March 8, 2008 at 2:22 pm

    Jack, it is good to see you! I think you are the same Jack who was so nice when I was very open at Millennial Star one time. Hope if one of my favorite words. Oh, how I did not know if I could even hope to hope at one time. And there has been so much good since then. I hope that you have a flood of Sunshine, brother!

    Ray, thank you for sharing your impressions. Also, I appreciate your words talking about addressing the problem of depression.

    I am grateful for Priesthood leaders who over all did not minimize my mental health problems. In addition, one of my Bishops encouraged me to get professional help and offered to have the fast offering pay for it. I did allow that for about two times but as I had money at the time, I paid for further visits and used my work’s insurance after a time. The dignity respect and kindness by him and another Bishop who spent hours trying to help me progress have made such a difference. If I were told that I was evil or that I should just pray enough to get over it etc etc etc, I don’t know what would have become of me. Oh, I was so shaken up inside. I would not have believed that I could form an identity around my problems that is pretty good in so many ways. I would not believe that I could forge a life that I feel has meaning. Well, I hope online activity counts in a meaningful life as it is important part of my life. :)

    I probably better go back to lurking before I put my foot in my mouth. I probably already have. :-\

  82. Bob on March 8, 2008 at 2:44 pm

    #80: Maybe it’s just because I am here in California, that I don’t see the stigmatizing you do. You just about have to get to Cocaine here before people judge you by your pills. Now how white your teeth are…that’s a whole different thing.

  83. Stephanie on March 8, 2008 at 5:51 pm

    #72 – I think you hit it on the head. Having young children (especially a lot of them) is just hard. Just because a mom of young children is tired, cranky, even depressed doesn’t mean she necessarily would make different choices. At least in the church we know about enduring to the end and having faith that tomorrow will be a brighter day.

  84. Ellis on March 8, 2008 at 8:45 pm

    As the relative of mental heal care consumers living in Utah I can say with confidence that the system there is one of the better ones in the United States. The system in place is more activists in encouraging consumers to use medication than in some states. Unfortunately or fortunately as the case may be medicine alone is not enough to restore a persons well being and insure recovery.

    There is research being done on the brain now that indicates that there are underlying physical causes for depression and other major mental illnesses. Maybe the long dark winters influence the prevalence of depression. Maybe there is a hereditary component. Maybe there is some kind of stress related trigger for a biological tendency. It is time to stop blaming parenting etc. for this disease. It is not caused by the LDS lifestyle.

    Unfortunately, only those who experience debilitating major depression can know what it is like to live with. I’ve never seen a study that dealt with that.

  85. Bob on March 8, 2008 at 8:54 pm

    Ray, don’t hear me wrong, I see no stigma in taking Anti- depressants. Nor do I see it is wrong for the Church not to see it as a stigma of it’s members.
    I do think the Church needs to look at these studies. Maybe there is something in the Mormon lifestyle that can bring both joy, and sometimes depression.(?) Also, the Church’s hands are not so clean about stigmatizing people for ‘self-medicating’ with coffee, a glass of wine, or tobacco.
    Myself, I take the usually “For your Heart Stuff” = Pill for HBP, pill for Cholesterol, pill for High Anxiety, and a walk.

  86. Jack on March 8, 2008 at 9:33 pm

    Ray,

    Thanks for your comment (#77) that really means a lot to me–and it’s well timed to boot!

    Barb,

    Yep, this is the same ol’ Jack. It’s good to see you too–and I’m glad you’re making progress! And I’m glad to hear that you’ve had such a good experience with your local leaders. I’ve had the same with mine–they’ve been wonderful. Without that support I’d probably be lying in a ditch somewhere.

  87. Bob on March 8, 2008 at 10:18 pm

    Churchill called his Depression ” My Black Dog”.
    The ” Black Dog Institute” has a great logo based on this- Google it.

  88. kurt on March 8, 2008 at 10:34 pm

    The whole premise behind Utah being the most depressed state in the nation is completely flawed. It is based only on the number of antidepressants prescribed. There are many factors affect this. As a family practice doctor here in Utah, I can tell you that physicians here are much quicker to prescribe anti-depressants than they are in the other parts of the country where I have practiced. Also, my employer Intermountain Health Care, the largest health care system in Utah, has an excellent depression screening system where they give the PHQ9 (a depression questionnaire) to every patient that walks into a primary care physician’s office, regardless of what they are there for. So we probably catch and treat much more depression than they do elsewhere. (I would argue that this is a good thing.)

    Since I first heard about the supposed high rates of depression in Utah, I started quietly paying more attention to my depressed patients’ religion. This has been no more scientific than the anti-depressant studies sited previously, but I can usually tell the devout, adult Mormons by their garments. (I realize it might be disconcerting to know that I’m paying attention to my patient’s underwear, but it’s almost impossible to ignore when they are down to their undies for an exam.) I have seen no correlation between activity in the LDS church and depression. I ask all my patients with depression what problems in their life they think make their mood worse. The most common stressors leading to depression reported by my patients seem to be marital infidelity, drug and alcohol abuse, and problems at work. In over 10 years of medical practice (most in Utah) I cannot remember a single incident where someone reported their religion, or even anything remotely related to their religion, as being a stressor leading to depression.

    It would be easy for researchers to find out which state in the Union is really the most depressed. All they would have to do is randomly send out PHQ9s all over the country and rate each state by average score. But it’s much easier just to assume Mormonism causes depression.

  89. kurt on March 8, 2008 at 10:37 pm

    typo above. It should read “There are many factors that could effect this number.”

  90. Clark on March 8, 2008 at 10:59 pm

    Kurt, I believe that was what the second study did. It was a survey and not based on drug use.

  91. Clark on March 8, 2008 at 10:59 pm

    Kurt, I believe that was what the second study did. It was a survey and not based on drug use.

  92. C.Biden on March 8, 2008 at 11:14 pm

    Would someone please explain to me why people getting medical help for a problem is a problem? The article is such a mishmash of anecdotes that it cannot be taken seriously. But if it is true that people in the Rocky Mountain West have a higher incidence of depression, isn’t it good that they seek treatment?

  93. kurt on March 9, 2008 at 12:23 am

    I stand partially corrected. They ABC article did not go into details of the MHA study so I went to the original article here:

    http://www.mentalhealthamerica.net/files/Ranking_Americas_Mental_Health.pdf

    This study did, in fact, do a randomonized phone survey across the country, and it seems pretty reliable.

    I still stand by my informal study that shows the use of temple garments does not correlate with depression.

    Here’s another way to look at the study. Perhaps people in Utah are just more honest answering the questions. Reading through the survey they used I’m sure they would have called me depressed.

    Actually, I have a testimony that it’s because of lack of mental health providers in Utah. Trying to get a patient into see a psychiatrist here is like pulling teeth. (Actually, pulling teeth in Utah is probably easier with our over supply of dentists.)

  94. Reppat on March 9, 2008 at 12:36 am

    Where is church PR on this one? They had time to deal with the Danzig affair…..this seems much more respnse worthy!

  95. Bob on March 9, 2008 at 1:44 am

    No problems in Zion? Why wasn’t Utah found to be the LEAST depressed State, instead of #1? You find this only a PR problem?

    ” Trying to get a patient into see a psychiatrist here is like pulling teeth” Are you saying if more saw a psychiatrist, there was be less Anti-depressants given out? Are you saying Anti-depressants are given to non-depressed people? Are you saying Mormons are twice as open about taking about their depression than other Americans?

  96. m&m on March 9, 2008 at 3:38 am

    I do think the Church needs to look at these studies.

    A BYU professor (who is now in the general SS presidency) did do just that.

    Barb, Tatiana, can you email me? mulling_and_musing (found at) hotmail d’ com.

  97. Liz on March 9, 2008 at 9:02 am

    Thanks for sharing, Ray. I really, really needed that today.

    As an LDS mother of 4 young children, and having suffered from depression at times, like others who commented on this blog I immediately wondered why there was no mention in the stats as to what percentage of depressed women were postpartum and/or stay-at-home moms with young children. I also think it’s interesting that the implication was that states like California, where harmful substance abuse is certainly more pervasive, were portrayed as being better off than the prescription drug using Utah.

    Besides, why would an active mormon woman like myself be depressed when I live in a society where the women must be waifishly thin and free of physical flaws to be heroic or attractive, where your identity is built on your outside of the home career/volunteerism (working in the home to raise responsible adults doesn’t qualify), where your faith is not socially accepted, and where you have to do/have it ALL (career, family, looks, money) or you might as well cast yourself as the comic relief in the next blockbuster movie?

    It must be because I have a supportive husband who loves me the way that I am, beautiful children who provide moments of pure joy within the trying challenges of motherhood, the doctrines that inspire me to be all I can be and tell me I am more than I think I am…
    or maybe it’s the moments of service that lift me higher than a kite…

    As a mormon woman, I err the most when I listen to the world more than I listen to God. Not an easy task, when the world is practically screaming “you’re not good enough” in your ear.

  98. kurt on March 9, 2008 at 11:32 am

    I’ve read through more of the MHA study again this morning, and the more I read, the less I believe anyone can say Utah’s high depression rating has anything to do with Mormonism.

    The numbers they looked at were the number of adolescents experiencing a major depressive episode (Utah had 10.4%, 1.49% above the average, with Nevada, Idaho and Connecticut higher than Utah), adults experiencing a major depressive episode (Utah was number 1 with 10.14% – 2.09% above the national average), adults with “serious psychological distress” (Utah had 14.58%, 2.95% above the national average with West Virginia and Kentucky higher than Utah), and poor mental health days (Utah had 3.27 days compared to the national average of 3.31 days – we’re about average here). They used these numbers to come up with a “composite depression index” by subtracting the state mean from the value for the individual state and dividing by the standard deviation.

    While I’m not convinced this “composite depression index” is a valid measure of an entire states mental health, lets look at the one measure where Utah did rank number one, the percent of adults reporting a major depressive episode. 10.14% of adults in Utah had a major depressive episode compared to an 8.95% national average. This is 2.09% above the national average. In a state that is now less than 70% LDS, and where the activity rate in the LDS church is barely above 50%, to attribute that 2.09% difference to Mormonism is a huge stretch. I could just as easily argue that the extra 2.09% is made up of non-Mormons who don’t like living with Mormons, or Jack Mormons who are depressed because they have to drink watered-down Utah beer.

    The study does not rank states by overall happiness, only the percentage who were actually depressed. If they ranked states by overall PHQ9 score, the low scores could very well even out the high scores. We may never know.

    Another measure that was interesting, but didn’t go into the “composite depression index” was suicide rates. Utah ranked 45th out of 51. What is interesting is that Utah rates about in the middle of the intermountain states for suicide rates. We are doing worse than Arizona and Colorado, but better than Idaho, Wyoming, New Mexico, Nevada and Alaska. Is it high altitudes that make us kill ourselves?

  99. kurt on March 9, 2008 at 11:41 am

    “Why wasn’t Utah found to be the LEAST depressed State, instead of #1?”

    I have no idea, but to blame it on Mormonism is horrible science, and to hold the church responsible for every problem in Utah is just crap.

    “You find this only a PR problem?”

    I don’t see this as a PR problem for the church, if that’s what you mean. Like I said, there is no evidence that this has anything to do with the church.

    “Are you saying if more saw a psychiatrist, there was be less Anti-depressants given out? Are you saying Anti-depressants are given to non-depressed people? Are you saying Mormons are twice as open about taking about their depression than other Americans?”

    Once again, I have no idea, but this study doesn’t address these questions either. For all I know more anti-depressants are given to non-depressed people in Utah. Maybe Mormons are more are more open in talking about depression. Those would be hard things to measure.

  100. East Coast on March 9, 2008 at 2:13 pm

    “Is it high altitudes that make us kill ourselves?”

    Well, altitude can have a range of physiological effects. You know that. Do people living at higher levels have lower blood oxygen saturation levels? Is it a significant number? If it is, could it affect mood?

  101. Bob on March 9, 2008 at 2:32 pm

    #99: No one blamed the Church (at least not me)”for every problem in Utah”
    NOT to take a look at Mormonism in Utah as a possible factor for it being #1, would be ” horrible science”.
    “The truth is, we don’t know why,” said Dr. Ted Wander, spokesman for the Utah Psychiatric Association. I agree.

  102. Stephanie on March 9, 2008 at 2:35 pm

    #97 – Great way to put it all into perspective!

  103. Ellis on March 9, 2008 at 4:09 pm

    “Are you saying if more saw a psychiatrist, there was be less Anti-depressants given out? Are you saying Anti-depressants are given to non-depressed people?”

    I can’t speak to what the person who made the original statement meant, but when most antidepressants are prescribed by physicians other than psychiatrists one has to wonder if that might not be the case. Antidepressants don’t work for everyone and it is well known that other therapies CBT, etc. are effective when combined with meds and family support. Most of the people prescribing anti-depressives may very well not be psychiatrists.

  104. Clark on March 9, 2008 at 9:52 pm

    NOT to take a look at Mormonism in Utah as a possible factor for it being #1, would be ” horrible science”

    However to treat an untested hypothesis as a conclusion is bad reporting and bad science.

  105. Bob on March 9, 2008 at 10:47 pm

    #104: I agree.
    The conclusion of the of the article is “The reason for Utah’s mass depression, however, is unknown. “.

  106. Cordeiro on March 10, 2008 at 8:43 am

    I’ve got to hand it to Russell Goodman. He went and found a woman (Wendy) who’s life redefines “Train Wreck” to lead off his hatchet job of a column. Let’s review her statement, shall we?

    But life has a funny way of not being perfect. Three years into my marriage my husband was drinking, using drugs and stepping out on me.

    I submit Wendy’s reasons for depression don’t lie with the Church. Evidently she kept living with (and having children by) a drunk druggie who was two/three/four timing her. I’m not a head shrinker, nor do I play one in the Bloggernacle. That said, it seems to me the cause of Wendy’s problems are extra-ecclesastical.

    Wendy’s secret isn’t Utah’s secret. Goodman would have the reader believe Mormon husbands have a sell-by date of about three years. That would put me about 11 years past due.

    ABC has some decent TV shows. This cannot be said for their news coverage.

  107. Ellis on March 10, 2008 at 1:13 pm

    If antidepressant use helps lower suicide rates, and there is research that indicates it does. Then assuming people in Utah are taking the antidepressants they are prescribed the suicide rate should be lower not higher. There is something wrong with this study.

    Perhaps people aren’t taking the meds they are prescribed. Maybe their is no crisis intervention plan in place.

    Something is not right. It does not make sense.

  108. Barb on March 10, 2008 at 1:30 pm

    As I do not have your email, Jack, I want to take another moment to reply here. I hope you can hold on whenever you have hard times. I will think on people have been nice to me even in passing when I feel hurt and betrayed by so many. Jack, your kindness has meant a lot to me. A few kind words go far sometimes! And I like what you have to say as you know. Whenever your are depressed, those are irrationale times. I know how it can feel in a mood swing. I do want to report that my home situation has been so great as of late. And I have felt pretty happy much of the time.

    As far as antidepressants and suicide, I don’t know all the information. I know for some ages that certain anti-depressants can increase suicidal thoughts and put people at risk for behavior. However, anti-depressants when properly prescribed have helped many people. I read a study about a woman in the early years of Prozac who had become stable and broke up with a bad man when taking Prozac. She was always the type even before that to take care of everybody. She never had energy until taking Prozac. I have another friend who was able to deal with his painful and nightmare past when he took an anti-depressant that gave him enough energy. Of course, there are many with a chemical need for an anti-depressant(or some other alternative therapy such as a special light or exercise regiment) who do not have such a traumatic past as those mentioned.

    Why is it that I seem to make comments and come out of lurking when people discuss mental health? I really want to be associated with more than mental illness.

  109. East Coast on March 10, 2008 at 2:23 pm

    “Why is it that I seem to make comments and come out of lurking when people discuss mental health?”

    It’s called advocacy. It means “public support for a particular cause or policy”, and it comes from an old word meaning to “summon or call to aid.” Sometimes it merges with a personal ministry to help those who are suffering.

    Here are a few examples of advocacy for mental health.

    1. Gordon Smith, senator from Oregon. After his family was touched in a tragic way by mental illness, he wrote a book about the experience and sponsored a bill to help fund suicide prevention at colleges.

    2. Mary Jo Codey, former first lady of New Jersey. During her husband’s unexpected term as governor, she used the limelight to focus attention on the problem of postpartum depression and encourage positive legislation addressing the issue.

    3. Barb and Jack and others who are willing to talk about the subject and provide information and personal experiences when the issue is discussed.

    Advocacy or a personal ministry can be a vital part of healing from the effects of a life-changing experience. I discovered this by accident when I started to realize the positive side-effects of being a resource for other mothers whose babies were diagnosed with the same major health problem as mine.

  110. Christian on March 10, 2008 at 5:45 pm

    NOT to take a look at Mormonism in Utah as a possible factor for it being #1, would be ” horrible science”

    Who on this board said that scientists should not look into whether the “mormonism” was a factor?

    The complaints here are against those that seem to want us to mindlessly assume that LDS church teachings are the cause and “do something about it.”

  111. Jim Cobabe on March 10, 2008 at 6:01 pm

    Perhaps the generally depressed mental state of so many Utah Mormons is a result of too much time spent in the Bloggernacle.

  112. Raymond Takashi Swenson on March 10, 2008 at 6:50 pm

    I have had relatives who have suffered from various mental health problems, most of which fit into various subcategories of depression (including Obsessive-Compulsive Disorder, OCD). It seems clear to us in the family that there is a genetic aspect to it. Frankly, the old Freudian notion that mental illness is the result of environment does not fit with the modern science that shows direct correlations with differences in chemical aspects of cognition, such as serotonin levels and different rates of reuptake of that brain chemical that is involved in transmission of signals across the synapse between neurons. Being depressed because of life circumstances is not the same thing as being depressed because one’s brain chemistry is of a particular kind. People who have the latter issue in their DNA will experience more depression, enough to reach “clinical” diagnostic levels, regardless of their life circumstances.

    As modern medical science allows us to see what is going on in the brain, it becomes clearer that problems of mental function are problems with the function of a physical organ and body chemistry, no different fundamentally or morally than the problems that cause Diabetes. Freud’s psychotherapy gave rise to the belief that mental illness is often due to something that someone else had done to you, and the notion of blaming depression on a church is no different than blaming your parents. The scientific truth is that it is part of mankind’s fallen and imperfect nature, like myopia. Generating guilt in anyone does nothing to mitigate the problem, which is unavoidable in its genesis.

    The kind of “Molly Mormon” concept that the article tries to sell as a hypothetical cause of depression is actually, in my view, a symptom rather than a cause. People who are predisposed toward OCD will display that underlying condition through their behavior in the settings of family, church, school and work. The observation that we can usually think of someone like that tells us more that someone is displaying their symptoms through their life, not that our shared lifestyle causes the symptoms. I certainly do not see a correlation between simple activity in the Church and depression. In fact, my own observation is that those who are more depressed tend to be less involved in Church activity. Are the presidents of the Relief Society, Young Women and Primary programs the most depressed of all LDS women? Your stake and ward leaders in those programs?

    The one function of the “Molly Mormon the Depressive” myth is that it gives LDS women who happen to be among the depressed an excuse for avoiding aspects of Church involvement, claiming it will make them worse. Furthermore, it seems to me that anyone who is actually caught up in compulsive bahavior to try to appear better than one is would militate against admitting even to oneself that one has a mental health condition needing treatment. Having insight to recognize one’s own mental illness seems to me to be inconsistent with feeling driven to perfection in practice. Yet the point of the story is to report high levels of people asking for treatment, evidence which seems to point to a LOWER incidence of a perfectionist obsession.

    On the other hand, the hypothesis of behavior therapy is that such myths are self-defeating, and that the best thing we can do when our mental health tends to be debilitating is to fight back and get involved in positive activities that reject the power of the illness over our lives. That seems to be especially true for OCD, where brain studies seem to support the idea that fighting back against OCD compulsions actually changes the way our brains work. From that standpoint, stories like this article that propose blaming the Church for your depression do a real disservice to people who would be helped by participating in positive interactions with others to the extent of their ability.

    Anyone who is actually a church member knows that the Church does not emphasize in general being successful in professional achievement and civic involvement for women. Nor is their emphasis on material wealth, displayed by expensive clothing and other costly adornments for one’s children. Rather, the emphasis placed by the Church is on prioritizing what is most important in one’s emotional health and for the church and society, by making sacrifices to spend as much time as possible with one’s children in a nurturing role. The heroes held up in Church talks and magazine articles are people like Jane Clayson who left a career in national TV behind to become a full time mother. There are certainly professional women of prominence in the Church, like Shari Dew, a very impressive person. But even sister Dew in her own books does not emphasize worldly career standards as an ideal for LDS women. Our relationship with God, with family, and other members of the Church are her emphasis. Most of the literature written for the LDS women’s market reflects an appreciation for the limits on what we can accomplish and hence the need for priorities AND sense of humor (I would think Shari Dew’s influence may be manifest here). Thus, “Murdering your husband is not an option” is a title of one recent LDS women’s book.

    Additionally, the notion that men can “have it all” has been debunked from the days of David O. McKay, with his watchword about making home and family a priority over other kinds of success. The adoption of the Sunday block meeting schedule was an explicit reaction to the need to reduce the time demands of the Church on the lives of fathers and mothers so they could place their families first. So I find the criticism of the Mormon ideals taught to women to really come more from assumptions that what Mormon women need to do is chuck the kids and hang out down at the day spa, or go to law school and become a corporate attorney. And of course, we know that businesses would NEVER tell employees that they should give all their time and talents to their work, to the exclusion of families and churches. It is still more the exception than the rule when a business does not effectively consider itself the first priority in the lives of its employees. By contrast, the Church has institutionalized a prioritization that makes families first, church second, and material achievement third, a program that supports saying “No” to excessive burdens with low returns. Those who attack the Church’s priorities usually claim to be advocating placement of the woman herself at the top of the list, but in practical terms that is often an invitation to selfishness or an invitation to make one’s business career one’s god.

    I am interested in the notion that altitude and lower oxygen pressure may have a general effect on incidence of depression in the Mountain States. Again, brain activity is an electro-chemical process, which depends on the combustion of carbohydrates by nerve cells, which is obviously an oxygen-intensive process. Neurons cannot metabolize proteins or fats. Studies have found that a small amount of carbohydrates supplied by chewing gum can improve test scores. I have sleep apnea, and need supplemental oxygen at low pressure when I sleep to maintain my blood-oxygen levels. I live around 5000 feet altitude. During a stay at a mountain cabin a couple of years ago, around 8000 feet altitude in the Rampart Range near Pike’s Peak, I found it almost impossible to sleep. Extreme altitude changes, such as riding the train to the top of Pike’s Peak (14,000 feet) can make one physically ill, and cause panic attacks and other emotional symptoms. It seems plausible that living in a region with lower effective oxygen levels could increase the number of people experiencing the mental effects of less than optimal brain function. Like most phenomena, such effects seem likely to be on a curve, with slightly low oxygen affecting a small part of the population.

    Some studies I am aware of have argued for a correspondence between blood sugar levels and depression and anxiety. Again, blood sugar levels directly affect mental function, and things like Diabetes and the medications used for diabetes can have very pronounced acute effects on mental function, emotions and behavior. The prevalence of green jello and tater tot casseroles and their carbohydrates may actually have a transient role in mental and emotional states.

    Finally, as one commenter noted, the statistics used to classify Utah as “worst” on some measures are variations over a small range throughout the 50 states. The survey asked for self-reporting of “episodes” of depression, as opposed to collecting data on actual clinical diagnosis. Some state was going to be put at the bottom of the average number derived, but it this is nothing but raw data as opposed to anything that really tells us anything about the cause or treatment of mental illness. The primary function of the survey was not a scientific study, but as a means to whip up funding support for mental health services nationwide. There is no evidence that the study really produced any meaningful conclusion. The study was an effort to “sell depression” and mental health services. It was guaranteed to make half the states feel bad about their mental health services. There is no evidence in the study that any level among the range of states was actually less than one ought to expect, or pathological per se. We may in fact be ALL very healthy mentally. But the study was reported as if, with enough money spent on mental health services, we could eliminate all depression, and it was an obligation of states to fund it.

  113. East Coast on March 11, 2008 at 12:13 pm

    I very much enjoy your comments, Bro Swenson, including this one.

    The question of the effect of low oxygen levels is being followed very closely in one particular group: children with cyanotic congenital heart defects.

    For those who may not know the terms, cyanosis is skin blueness and is an indication of low oxygen levels in the blood. Hypoxia means a shortage of oxygen in the blood.

    There are several cyanotic conditions including transpostition of the great arteries, tetralogy of Fallot, and the single ventricle conditions (HLHS, HRHS, etc.). Surgery is available for most of these conditions but some of these heart children spend years of their early development with oxygen levels ranging from 70 percent saturation to the mid 80s. Normal range is 95-98 percent.

    Now that more of these children are living into adulthood, some long term effects are being tracked. Depression does not seem to be one of them. ADHD, certain motor skill problems, and slightly lower IQ do tend to show up. If you’re interested in studies, you can google “wernovsky long term behavioral CHD” as a starting point.

    Because of these studies, I would tend to dismiss a connection between slightly lower oxygen levels and slightly higher reported levels of depression. I wouldn’t dismiss it altogether, though.

  114. Ellis on March 15, 2008 at 1:25 pm

    #113 Br. Swenson: A very cogent discussion of some of the more up to date thinking on mental illness as a physically brain disorder. It is interesting to note that there is research out now that is calling into question the classification of OCD as the same kind of illness as depression. Some are now thinking that OCD is a malfunction of the nervous system rather than the brain.

  115. Minerva on March 16, 2008 at 6:07 pm

    I think it very likely that there is a genetic reason for all of this. Isn’t it true that geneticists like to perform their work in Utah because it’s such a small gene pool? If a lot of us Utah Mormons are descended from the same pretty small group of people and some of them suffered from depression, it stands to reason that a lot of us are going to have the same problem. I actually think it is likely that we are from a grand old stock of people with bipolar disorder. One tell-tale sign of bipolar is grandiose actions: the undertaking of a trek across the plains is pretty grandiose. Perhaps the circumstances of the early church selected for people who were capable of such strong, even reckless conviction.

  116. Ray on March 16, 2008 at 6:18 pm

    minerva, that has been addressed already in the previous comments.

  117. East Coast on March 16, 2008 at 6:54 pm

    Actually, Ray, I don’t think that anyone in all the comments ever speculated that Brigham Young was bipolar. That’s a new one.

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