Spirituality can play a role in treating depression

We would like to commend Larzelere et al on their article, “Treating depression: What works besides meds?” (J Fam Pract. 2015;64:454-459). These authors pointed out that the value of medications is limited in patients with mild to moderate depression. They also noted that nonpharmacologic interventions have proven beneficial and that, specifically, cognitive behavioral therapy (CBT), interpersonal therapy, and problem-solving therapy have been linked to moderate to large improvements in depressive symptoms. We agree, and would also like to highlight the role of religion and spirituality in the context of CBT as a valuable treatment for depression.

Religion/spirituality is a protective factor against depression and has been proven to be beneficial in patients with mild to moderate depression.^1,2,3 In a randomized clinical trial that compared CBT that incorporated patients’ religion vs conventional CBT, Koenig et al found that religious and conventional CBT were equally effective in increasing optimism in patients with major depressive disorder and chronic medical illness.¹

Afolake Mobolaji, MD
Folashade Omole, MD, FAAFP
Atlanta, Ga

1. Koenig HG, Pearce MJ, Nelson B, et al. Effects of religious versus standard cognitive-behavioral therapy on optimism in persons with major depression and chronic medical illness. Depress Anxiety. 2015;32:835-842.

2. Miller L. Spiritual awakening and depression in adolescents: a unified pathway or “two sides of the same coin.” Bull Menninger Clin. 2013;77:332-348.

3. Balbuena L, Baetz M, Bowen R. Religious attendance, spirituality, and major depression in Canada: a 14-year follow-up study. Can J Psychiatry. 2013;58:225-232.